Healthcare Provider Details

I. General information

NPI: 1245255702
Provider Name (Legal Business Name): RAMON SOLHKHAH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 01/06/2020
Certification Date: 01/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 STATE ROUTE 33 # ROSA105D
NEPTUNE NJ
07753-4859
US

IV. Provider business mailing address

1090 AMSTERDAM AVE SUITE 16C
NEW YORK NY
10025-1737
US

V. Phone/Fax

Practice location:
  • Phone: 732-776-4931
  • Fax: 732-776-4929
Mailing address:
  • Phone: 212-523-2965
  • Fax: 212-636-1303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number203266
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA08905900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: