1629055710 NPI number — DR. MILDRED SOLANO M.D.

Table of content: DR. MILDRED SOLANO M.D. (NPI 1629055710)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629055710 NPI number — DR. MILDRED SOLANO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOLANO
Provider First Name:
MILDRED
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1629055710
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1209 HEMPSTEAD TPKE
Provider Second Line Business Mailing Address:
PRIMARY HEALTHCARE PLUS
Provider Business Mailing Address City Name:
FRANKLIN SQUARE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11010-1538
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-352-8300
Provider Business Mailing Address Fax Number:
516-352-8331

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1209 HEMPSTEAD TPKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKLIN SQUARE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11010-1537
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-352-8300
Provider Business Practice Location Address Fax Number:
516-352-8331
Provider Enumeration Date:
12/29/2005

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: 207Q00000X , with the licence number:  223117 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0136396 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 11178218 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000207730201 . This is a "HEALTHPLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3038133 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1000039787 . This is a "AFFINITY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 167323P . This is a "HIP" identifier . This identifiers is of the category "OTHER".
  • Identifier: P2706100 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 223117 . This is a "LICENSE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3C5962 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5295A1 . This is a "EMPIRE BC/BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: N94176 . This is a "GUARDIAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 223117B71 . This is a "HEALTHFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2250602 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 040426010123 . This is a "FIDELIS" identifier . This identifiers is of the category "OTHER".
  • Identifier: WJW871 . This is a "MEDICARE GROUP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 02333466 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2475022006 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".




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