Basic Information
| Provider Information | |||||||||
| NPI: | 1184621286 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOLANKI | ||||||||
| FirstName: | JAYANT | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 111 CLOCK TOWER CMNS | ||||||||
| Address2: | |||||||||
| City: | BREWSTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105094055 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8455924915 | ||||||||
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| Practice Location | |||||||||
| Address1: | 400 WESTAGE BUS CTR DR STE 202 | ||||||||
| Address2: | |||||||||
| City: | FISHKILL | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125242266 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8458960736 | ||||||||
| FaxNumber: | 8458964850 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2005 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 129073 | NY | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 12230 | NH | N | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 050063603 | 01 | NY | RAILROAD MEDICARE | OTHER | 30203834 | 05 | NH | MEDICAID | 00919255 | 05 | NY | MEDICAID | CE9959 | 01 | NY | RAILROAD MEDICARE GROUP | OTHER |