Healthcare Provider Details

I. General information

NPI: 1932297207
Provider Name (Legal Business Name): ARLENE R SOLOMON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/13/2022
Certification Date: 07/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 MANCHESTER RD. SUITE 105
POUGHKEEPSIE NY
12603-2587
US

IV. Provider business mailing address

301 MANCHESTER RD. SUITE 105
POUGHKEEPSIE NY
12603-2587
US

V. Phone/Fax

Practice location:
  • Phone: 845-452-1700
  • Fax: 845-452-1752
Mailing address:
  • Phone: 845-452-1700
  • Fax: 845-452-1752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number159190
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier01027792
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: