Individual
ANITA M SOLOMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-A, F-AAA
Contact information
Practice address
295 LINCOLN ST, SUITE 105, WORCESTER, MA 01605-3639
(508) 755-1391
(508) 363-4019
Mailing address
295 LINCOLN ST, STE 105, WORCESTER, MA 01605
(508) 755-1391
(508) 363-4019
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
762
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26550
FALLON
—
01
—
5104033
MASS HEALTH
—
05
—
5104033
—
MA
01
—
AD0187
AETNA
—
01
—
SO 039764
MEDICARE ID
MA
Enumeration date
11/20/2006
Last updated
12/03/2007
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