Provider Demographics
NPI:1992087688
Name:CHANG, SOLOMON (PHARM D)
Entity type:Individual
Prefix:
First Name:SOLOMON
Middle Name:
Last Name:CHANG
Suffix:
Gender:
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:584 NEW LOUDON RD # 785-8086
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-4024
Mailing Address - Country:US
Mailing Address - Phone:518-785-8086
Mailing Address - Fax:
Practice Address - Street 1:584 NEW LOUDON RD # 785-8086
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-4024
Practice Address - Country:US
Practice Address - Phone:518-785-8086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056290183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist