1538413182 NPI number — KINJAL SOLANI PT

Table of content: KINJAL SOLANI PT (NPI 1538413182)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538413182 NPI number — KINJAL SOLANI PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOLANI
Provider First Name:
KINJAL
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538413182
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/19/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1895 MOWRY AVE
Provider Second Line Business Mailing Address:
SUITE #118A
Provider Business Mailing Address City Name:
FREMONT
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94538-1737
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-790-0383
Provider Business Mailing Address Fax Number:
510-790-1197

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1895 MOWRY AVE
Provider Second Line Business Practice Location Address:
SUITE #118A
Provider Business Practice Location Address City Name:
FREMONT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94538-1737
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-790-0383
Provider Business Practice Location Address Fax Number:
510-790-1197
Provider Enumeration Date:
11/05/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  41031 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225100000X , with the licence number: 035051 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 035051 . This is a "STATE LICENSE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 41031 . This is a "STATE LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".