Provider Demographics
NPI:1962913889
Name:MUNIZ, SOLANGEL
Entity type:Individual
Prefix:
First Name:SOLANGEL
Middle Name:
Last Name:MUNIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SOLANGEL
Other - Middle Name:
Other - Last Name:MONTILLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:32 HARVEST LN
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-1508
Mailing Address - Country:US
Mailing Address - Phone:631-499-0208
Mailing Address - Fax:
Practice Address - Street 1:32 HARVEST LN
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-1508
Practice Address - Country:US
Practice Address - Phone:917-400-6551
Practice Address - Fax:917-400-6551
Is Sole Proprietor?:No
Enumeration Date:2017-10-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator