Healthcare Provider Details

I. General information

NPI: 1285721639
Provider Name (Legal Business Name): RONALD SOLOMON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 01/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 MONTAGUE ST 4TH FLOOR
BROOKLYN NY
11201-3600
US

IV. Provider business mailing address

PO BOX 13252
BELFAST ME
04915-4023
US

V. Phone/Fax

Practice location:
  • Phone: 718-625-4975
  • Fax: 718-625-8312
Mailing address:
  • Phone: 718-625-4975
  • Fax: 855-851-6744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number135946
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: