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General NPI Number Information
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NPI Number | 1689623621
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Entity Type | Individual
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Provider Name | PEGGY A SOLOMON-BERGEN M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 06/04/2020
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Provider Practice Location Address
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Address Line | 1301 ATLANTIC AVE
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City | ATLANTIC CITY
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State | NJ
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Zip | 08401-7247
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Country | US
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Telephone | 609-572-0000
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Fax | 609-572-0039
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Provider Business Mailing Address
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Address Line | 1 N WHITE HORSE PIKE
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City | HAMMONTON
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State | NJ
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Zip | 08037-1875
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Country | US
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Telephone | 609-567-0434
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Fax | 609-567-1169
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 25MA04422100
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License Number State | NJ
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