Basic Information
| Provider Information | |||||||||
| NPI: | 1326690330 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOLIS | ||||||||
| FirstName: | DANIELLE | ||||||||
| MiddleName: | WESLEY | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25310 NORTHERN BLVD UNIT 2F | ||||||||
| Address2: | |||||||||
| City: | LITTLE NECK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113621414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2396825535 | ||||||||
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| Practice Location | |||||||||
| Address1: | 424 E 34TH ST | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100164901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122637300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2019 | ||||||||
| LastUpdateDate: | 07/10/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 023637 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.