MEDICARE: DR. PEARCE SLOAN D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	N004432	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	101965EQ	OTHER	NY	PREFERRED CARE
3	010044320	OTHER	NY	EXCELLUS

General Provider Information

NPI Number	:	1154388023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PEARCE SLOAN D.P.M.

Provider Business Mailing Address
First Line	:	1081 LONG POND RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14626-5002
Country	:	US
Telephone Number	:	585-723-3630
Fax Number	:	585-723-3689

Provider Business Practice Location Address
First Line	:	1081 LONG POND RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14626-5002
Country	:	US
Telephone Number	:	585-723-3630
Fax Number	:	585-723-3689

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	07/25/2007

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