Healthcare Provider Details

I. General information

NPI: 1598271983
Provider Name (Legal Business Name): MEGAN C.B. SOLYAK PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN C BURGER LAT, ATC

II. Dates (important events)

Enumeration Date: 12/20/2017
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 PETERS ROAD STE 200
LITITZ PA
17543-7685
US

IV. Provider business mailing address

51 PETERS ROAD STE 200
LITITZ PA
17543-7685
US

V. Phone/Fax

Practice location:
  • Phone: 717-626-2167
  • Fax: 717-626-1915
Mailing address:
  • Phone: 717-626-2167
  • Fax: 717-626-1915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberRT004423
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA059690
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA059690
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: