Healthcare Provider Details

I. General information

NPI: 1154388023
Provider Name (Legal Business Name): PEARCE SLOAN D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1081 LONG POND RD
ROCHESTER NY
14626-5002
US

IV. Provider business mailing address

1081 LONG POND RD
ROCHESTER NY
14626-5002
US

V. Phone/Fax

Practice location:
  • Phone: 585-723-3630
  • Fax: 585-723-3689
Mailing address:
  • Phone: 585-723-3630
  • Fax: 585-723-3689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN004432
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: