Individual
DR. THERESA SOLASKI DAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
360 MONTAUK HWY, WEST ISLIP, NY 11795-4403
(631) 422-1110
Mailing address
360 MONTAUK HWY, WEST ISLIP, NY 11795-4403
(631) 422-1110
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
005592
NY
152W00000X
Optometrist
0618002137
VA
152W00000X
Optometrist
TA1461
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10036579
MEDICARE RR PIN
MD
01
—
54725501
CAREFIRST
MD
01
—
8185-0004
CAREFIRST
DC
Enumeration date
06/08/2005
Last updated
02/24/2023
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