Provider Demographics
NPI:1285964767
Name:SALOMON, ROLAND
Entity type:Individual
Prefix:MR
First Name:ROLAND
Middle Name:
Last Name:SALOMON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 VERMILYEA AVE APT C2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-4452
Mailing Address - Country:US
Mailing Address - Phone:917-658-1182
Mailing Address - Fax:
Practice Address - Street 1:83 VERMILYEA AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034
Practice Address - Country:US
Practice Address - Phone:917-658-1182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197655164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse