Individual
SOPHIA KONNACKAL SOLOMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 N VILLAGE AVE, ROCKVILLE CENTRE, NY 11570-1000
(516) 705-2525
Mailing address
214 DOHERTY AVE, ELMONT, NY 11003-3016
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
736836-1
NY
Other
Enumeration date
10/13/2020
Last updated
10/13/2020
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