Provider Demographics
NPI:1871096149
Name:SOLOMON, SIMONE OLEVEN
Entity type:Individual
Prefix:
First Name:SIMONE
Middle Name:OLEVEN
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SIMONE
Other - Middle Name:OLEVEN
Other - Last Name:JARRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:41 EHRBAR AVE APT 4G
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-3605
Mailing Address - Country:US
Mailing Address - Phone:914-771-1804
Mailing Address - Fax:
Practice Address - Street 1:41 EHRBAR AVE APT 4G
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10552-3605
Practice Address - Country:US
Practice Address - Phone:914-771-1804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion