Provider Demographics
NPI:1154704955
Name:SOLAKA, NADIN
Entity type:Individual
Prefix:
First Name:NADIN
Middle Name:
Last Name:SOLAKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1364 WORCESTER ST
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-1514
Mailing Address - Country:US
Mailing Address - Phone:508-655-8127
Mailing Address - Fax:508-652-0819
Practice Address - Street 1:1364 WORCESTER ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-1514
Practice Address - Country:US
Practice Address - Phone:508-655-8127
Practice Address - Fax:508-652-0819
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5096152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist