Provider Demographics
NPI:1144575630
Name:SOLANO, ROXANNA MONIQUE (LPN)
Entity type:Individual
Prefix:
First Name:ROXANNA
Middle Name:MONIQUE
Last Name:SOLANO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 WASHINGTON AVE
Mailing Address - Street 2:APT 4E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-2007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1350 WASHINGTON AVE
Practice Address - Street 2:APT 4E
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-2007
Practice Address - Country:US
Practice Address - Phone:347-297-3504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-20
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309092164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse