Provider Demographics
NPI:1063607802
Name:FREDERICK E. SOLOMON
Entity type:Organization
Organization Name:FREDERICK E. SOLOMON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESEDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-473-4444
Mailing Address - Street 1:44 LISPENARD ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-2550
Mailing Address - Country:US
Mailing Address - Phone:212-473-4444
Mailing Address - Fax:212-473-4477
Practice Address - Street 1:44 LISPENARD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-2550
Practice Address - Country:US
Practice Address - Phone:212-473-4444
Practice Address - Fax:212-473-4477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044174NY122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty