Individual
MAIMOUNA SOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
525 E 68TH ST, NEW YORK, NY 10065-4870
(212) 746-2302
Mailing address
629 CRANBURY RD FL 2, EAST BRUNSWICK, NJ 08816-4096
(732) 390-7750
(732) 390-7725
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP00519100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0749460
—
NJ
01
—
14948929
CAQH ID
NJ
Enumeration date
03/13/2018
Last updated
08/05/2024
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