Basic Information
Provider Information
NPI: 1679504336
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SOLIVEN
FirstName: EFIGENIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
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Mailing Information
Address1: 2 CATHARINE STREET
Address2: P O BOX 550
City: POUGHKEEPSIE
State: NY
PostalCode: 12602
CountryCode: US
TelephoneNumber: 8668688415
FaxNumber: 8457902675
Practice Location
Address1: 310 E 14TH STREET
Address2: NY EYE & EAR INFIRMARY
City: NEW YORK
State: NY
PostalCode: 10003
CountryCode: US
TelephoneNumber: 2129794000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/05/2006
LastUpdateDate: 05/02/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X160476NYY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
0086586105NY MEDICAID


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