Healthcare Provider Details

I. General information

NPI: 1881091510
Provider Name (Legal Business Name): SOLO FITNESS AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2014
Last Update Date: 11/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 NEW DORP PLZ N
STATEN ISLAND NY
10306-2903
US

IV. Provider business mailing address

81 NEW DORP PLZ N
STATEN ISLAND NY
10306-2903
US

V. Phone/Fax

Practice location:
  • Phone: 718-356-1337
  • Fax: 718-356-1337
Mailing address:
  • Phone: 718-356-1337
  • Fax: 718-356-1337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Y00000X
TaxonomyClinical Exercise Physiologist
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH CAPUANO
Title or Position: PARTNER
Credential:
Phone: 917-974-0971