MEDICARE: DR. KIM WRIGHT SLOAN M.D.

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	207X00000X	Orthopaedic Surgery Physician	MA32112	NJ

General Provider Information

NPI Number	:	1255505541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIM WRIGHT SLOAN M.D.

Provider Business Mailing Address
First Line	:	1000 MORRIS AVE
Second Line	:	KEAN UNIV D'ANGOLA GYM #103
City	:	UNION
State	:	NJ
Zip	:	07083-7133
Country	:	US
Telephone Number	:	908-737-5520
Fax Number	:	908-737-5525

Provider Business Practice Location Address
First Line	:	1000 MORRIS AVE
Second Line	:	KEAN UNIV D'ANGOLA GYM #103
City	:	UNION
State	:	NJ
Zip	:	07083-7133
Country	:	US
Telephone Number	:	908-737-5520
Fax Number	:	908-737-5525

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

Provider Enumeration Date	:	04/17/2008
Last Update Date	:	07/30/2008

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