1740237627 NPI number — DR. ROBERT BASIL SOLLITTO M.D.

Table of content: DR. ROBERT BASIL SOLLITTO M.D. (NPI 1740237627)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740237627 NPI number — DR. ROBERT BASIL SOLLITTO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOLLITTO
Provider First Name:
ROBERT
Provider Middle Name:
BASIL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1740237627
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 VAN BUREN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VOORHEES
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08043-2370
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-770-0800
Provider Business Mailing Address Fax Number:
856-770-4996

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 VAN BUREN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VOORHEES
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08043-2370
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-770-0800
Provider Business Practice Location Address Fax Number:
856-770-4996
Provider Enumeration Date:
05/27/2006

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: 207ND0101X , with the licence number:  25MA06503100 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0860589000 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2100770 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 223612347 . This is a "CIGNA PPO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0292647000 . This is a "KEYSTONE HEALTH PLAN EAST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 223612347 . This is a "UNICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 706996 . This is a "AMERIHEALTH PPO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 223612347 . This is a "HORIZON BC/BS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 223612347 . This is a "TRICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 223612347 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 223612347 . This is a "DEVON" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 223612347 . This is a "QUALCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 223612347 . This is a "BLUE CROSS/BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 223612347 . This is a "BEECH STREET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 920334 . This is a "AMERIHEALTH BLAIR MILL" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: S0706996 . This is a "FEDERAL BC/BS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: S0706996 . This is a "FEDERAL BC/BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0292647000 . This is a "AMERIHEALTH HMO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 223612347 . This is a "INTERGROUP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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