MEDICARE: DR. LAURIE SOLOMON MD

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	207V00000X	Obstetrics & Gynecology Physician	167211	NY

General Provider Information

NPI Number	:	1588677066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURIE SOLOMON MD

Provider Business Mailing Address
First Line	:	20 ROSE HILL RD
Second Line	:
City	:	SUFFERN
State	:	NY
Zip	:	10901-3204
Country	:	US
Telephone Number	:	845-357-8884
Fax Number	:	845-357-8885

Provider Business Practice Location Address
First Line	:	257 LAFAYETTE AVE
Second Line	:	STE 380
City	:	SUFFERN
State	:	NY
Zip	:	10901-4830
Country	:	US
Telephone Number	:	845-357-8884
Fax Number	:	845-357-8885

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

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	09/07/2012

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