MEDICARE: DR. ERIC SETH SLONE 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	208200000X	Plastic Surgery Physician	153012	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2E622	OTHER	NY	MEDICARE OTHER

General Provider Information

NPI Number	:	1639285794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC SETH SLONE M.D.

Provider Business Mailing Address
First Line	:	39 BARNYARD LN
Second Line	:
City	:	ROSLYN HTS
State	:	NY
Zip	:	11577-2806
Country	:	US
Telephone Number	:	516-520-5294
Fax Number	:

Provider Business Practice Location Address
First Line	:	39 BARNYARD LN
Second Line	:
City	:	ROSLYN HTS
State	:	NY
Zip	:	11577-2806
Country	:	US
Telephone Number	:	516-520-5294
Fax Number	:

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

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	09/04/2014

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