Provider Demographics
NPI:1730259920
Name:SOLOWAY, BRUCE H (MD)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:H
Last Name:SOLOWAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 E 193RD ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-4710
Mailing Address - Country:US
Mailing Address - Phone:718-933-2400
Mailing Address - Fax:718-367-8168
Practice Address - Street 1:MONTEFIORE FAMILY HEALTH CTR
Practice Address - Street 2:360 EAST 193RD STREET
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458
Practice Address - Country:US
Practice Address - Phone:718-933-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168124207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine