Healthcare Provider Details

I. General information

NPI: 1447246194
Provider Name (Legal Business Name): RHONDA L SOLOMON PNP C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 05/22/2020
Certification Date: 05/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1991 BALSLEY RD
SENECA FALLS NY
13148-9714
US

IV. Provider business mailing address

196 NORTH ST
GENEVA NY
14456-1651
US

V. Phone/Fax

Practice location:
  • Phone: 315-539-0237
  • Fax: 315-539-0940
Mailing address:
  • Phone: 315-787-4006
  • Fax: 315-789-1678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF3337341
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: