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General NPI Number Information
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NPI Number | 1609255165
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Entity Type | Organization
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Legal Business Name | BARRY SLOAN, DO PA
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Dates
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Enumeration Date | 05/29/2015
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Last Update Date | 05/29/2015
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Provider Practice Location Address
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Address Line | 14 OAK ST
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City | ELMWOOD PARK
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State | NJ
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Zip | 07407-2020
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Country | US
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Telephone | 201-957-5864
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Fax |
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Provider Business Mailing Address
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Address Line | 14 OAK ST
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City | ELMWOOD PARK
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State | NJ
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Zip | 07407-2020
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Country | US
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Telephone | 201-957-5864
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Fax |
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. BARRY SLOAN
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Credential | D.O
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Telephone | 201-957-5864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204R00000X
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Taxonomy Name | Electrodiagnostic Medicine Physician
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License Number | MB53521
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | MB53521
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License Number State | NJ
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