Healthcare Provider Details

I. General information

NPI: 1104615715
Provider Name (Legal Business Name): SOLOMON DAVID, MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19616 HILLSIDE AVE FL 1
HOLLIS NY
11423-2125
US

IV. Provider business mailing address

1 SWEET HOLLOW RD
HUNTINGTON NY
11743-6530
US

V. Phone/Fax

Practice location:
  • Phone: 718-217-6806
  • Fax: 718-217-0339
Mailing address:
  • Phone: 917-370-1291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SOLOMON DAVID
Title or Position: PRESIDENT
Credential: MD
Phone: 917-370-1291