1366607418 NPI number — MRS. AMY H. SOLOMON MS, OTR

Table of content: MRS. AMY H. SOLOMON MS, OTR (NPI 1366607418)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366607418 NPI number — MRS. AMY H. SOLOMON MS, OTR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOLOMON
Provider First Name:
AMY
Provider Middle Name:
H.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS, OTR
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:
1366607418
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/09/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9568 LA QUINTA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LONE TREE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80124-4202
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-649-9031
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6535 S DAYTON ST
Provider Second Line Business Practice Location Address:
SUITE 3800
Provider Business Practice Location Address City Name:
GREENWOOD VILLAGE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80111-6125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-649-9007
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/28/2008

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: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2208 . This is a "REGISTRATION" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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