MEDICARE: CYNTHIA M SOLOMON LMSW

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1629211289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA M SOLOMON LMSW

Provider Business Mailing Address
First Line	:	590 SHEFFIELD STREET
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11207-6310
Country	:	US
Telephone Number	:	212-385-3030
Fax Number	:	718-485-4018

Provider Business Practice Location Address
First Line	:	590 SHEFFIELD STREET
Second Line	:	INSTITUTE FOR COMMUNITY LIVING, INC
City	:	BROOKLYN
State	:	NY
Zip	:	11207-6310
Country	:	US
Telephone Number	:	212-385-3030
Fax Number	:	718-485-4018

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

Provider Enumeration Date	:	04/13/2009
Last Update Date	:	04/13/2009

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