Basic Information
| Provider Information | |||||||||
| NPI: | 1760876767 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOLIMAN | ||||||||
| FirstName: | ISAAC | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 BAY AVE | ||||||||
| Address2: | |||||||||
| City: | MONTCLAIR | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070424837 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9734296916 | ||||||||
| FaxNumber: | 9734296575 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 BAY AVE | ||||||||
| Address2: | |||||||||
| City: | MONTCLAIR | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9734296196 | ||||||||
| FaxNumber: | 9734296575 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2015 | ||||||||
| LastUpdateDate: | 07/23/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 25MA10287600 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.