Provider Demographics
NPI:1366645665
Name:ROBERT E SLOANE MD PC
Entity type:Organization
Organization Name:ROBERT E SLOANE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:SLOANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-581-3280
Mailing Address - Street 1:480 LYNNFIELD STREET
Mailing Address - Street 2:EAST MEDICAL BLDG
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01904
Mailing Address - Country:US
Mailing Address - Phone:781-581-3280
Mailing Address - Fax:781-581-7990
Practice Address - Street 1:480 LYNNFIELD STREET
Practice Address - Street 2:LYNN EAST MEDICAL BLDG
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01904
Practice Address - Country:US
Practice Address - Phone:781-581-3280
Practice Address - Fax:781-581-7990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA30913208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0005557Medicare PIN