MEDICARE: DR. ANNA SLAVIN 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	207R00000X	Internal Medicine Physician	MA68746	NJ

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

General Provider Information

NPI Number	:	1417934712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNA SLAVIN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 639295
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-9295
Country	:	US
Telephone Number	:	248-266-4200
Fax Number	:	855-618-6655

Provider Business Practice Location Address
First Line	:	28 VALLEY RD # 148
Second Line	:
City	:	MONTCLAIR
State	:	NJ
Zip	:	07042-2709
Country	:	US
Telephone Number	:	973-559-4600
Fax Number	:

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

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	01/17/2024

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