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General NPI Number Information
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NPI Number | 1215123922
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Entity Type | Organization
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Legal Business Name | SOLOMON,EDWARD M M D P A ETAL PT
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Dates
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Enumeration Date | 09/18/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 85 SOUTH MAPLE AVE SUITE #4
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-4561
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Country | US
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Telephone | 201-444-5898
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Fax | 201-447-5775
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Provider Business Mailing Address
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Address Line | 85 SOUTH MAPLE AVE SUITE #4
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-4561
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Country | US
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Telephone | 201-444-5898
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Fax | 201-447-5775
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Authorized Official
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Title or Position | PARTNER
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Name | DR. BOYD H SEIDENBERG
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Credential | MD
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Telephone | 201-444-5898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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