Healthcare Provider Details

I. General information

NPI: 1013490200
Provider Name (Legal Business Name): DIANA MARY SOLOMON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2018
Last Update Date: 09/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 GEORGIA AVE NW
WASHINGTON DC
20059-0001
US

IV. Provider business mailing address

2300 4TH ST NW ATTENTION TO: DIANA SOLOMON, ANNEX 3 ROOM 135
WASHINGTON DC
20059
US

V. Phone/Fax

Practice location:
  • Phone: 202-865-4356
  • Fax:
Mailing address:
  • Phone: 631-561-8694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License NumberPHI000003315
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: