Provider Demographics
NPI:1285721639
Name:SOLOMON, RONALD (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13252
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4023
Mailing Address - Country:US
Mailing Address - Phone:718-625-4975
Mailing Address - Fax:855-851-6744
Practice Address - Street 1:185 MONTAGUE ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3600
Practice Address - Country:US
Practice Address - Phone:718-625-4975
Practice Address - Fax:718-625-8312
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1359462086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00764585Medicaid
NY00764585Medicaid