Healthcare Provider Details

I. General information

NPI: 1164249082
Provider Name (Legal Business Name): SOLAIKA BRUNET
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 TILDEN STREET
BRONX NY
10467
US

IV. Provider business mailing address

750 TILDEN ST
BRONX NY
10467-6013
US

V. Phone/Fax

Practice location:
  • Phone: 718-231-3400
  • Fax: 718-655-3503
Mailing address:
  • Phone: 718-231-3400
  • Fax: 718-655-3503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: