MEDICARE: LORIANN SOLANO LICENSED BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	000742	NY

General Provider Information

NPI Number	:	1538553474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORIANN SOLANO LICENSED BCBA

Provider Business Mailing Address
First Line	:	19 CEDAR RD
Second Line	:
City	:	ROCKY POINT
State	:	NY
Zip	:	11778-8916
Country	:	US
Telephone Number	:	631-793-7877
Fax Number	:

Provider Business Practice Location Address
First Line	:	19 CEDAR RD
Second Line	:
City	:	ROCKY POINT
State	:	NY
Zip	:	11778-8916
Country	:	US
Telephone Number	:	631-793-7877
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2015
Last Update Date	:	03/27/2015

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