Provider Demographics
NPI:1184663403
Name:SLOTOROFF, HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:SLOTOROFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 872
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NJ
Mailing Address - Zip Code:08240-0872
Mailing Address - Country:US
Mailing Address - Phone:609-652-6876
Mailing Address - Fax:609-652-5277
Practice Address - Street 1:72 W JIM LEEDS RD
Practice Address - Street 2:SUITE 1600
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9406
Practice Address - Country:US
Practice Address - Phone:609-652-6876
Practice Address - Fax:609-652-5277
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02325300208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ340001086OtherRAILROAD MEDICARE
NJC53064Medicare UPIN
NJ084550Medicare PIN