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NPI Code Detail

MEDICARE: JEFFREY DAVID SOLOMON RPH

MEDICARE: JEFFREY DAVID SOLOMON RPH
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
1183500000XPharmacist7209CT
2183500000XPharmacist38206NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1522759OTHERCTNABP

General Provider Information

NPI Number : 1679905285
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY DAVID SOLOMON RPH
Provider Business Mailing Address
First Line : 712 LAURIE LN
Second Line :
City : ORANGE
State : CT
Zip : 06477-1823
Country : US
Telephone Number : 203-506-0435
Fax Number : 203-882-5775
Provider Business Practice Location Address
First Line : 480 BOSTON POST RD
Second Line :
City : MILFORD
State : CT
Zip : 06460-2529
Country : US
Telephone Number : 203-877-7828
Fax Number : 203-882-5775
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2013
Last Update Date : 08/06/2013

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