Healthcare Provider Details

I. General information

NPI: 1962280420
Provider Name (Legal Business Name): MARIAM E SOLIMAN NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2023
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 COLUMBIA ST
POUGHKEEPSIE NY
12601-3906
US

IV. Provider business mailing address

90 WATCH HILL DR
FISHKILL NY
12524-1015
US

V. Phone/Fax

Practice location:
  • Phone: 845-231-5600
  • Fax:
Mailing address:
  • Phone: 845-264-0712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number311262
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number311262
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: