Provider Demographics
NPI:1235324583
Name:THOMAS L SLAMOVITS MD PC
Entity Type:Organization
Organization Name:THOMAS L SLAMOVITS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:SLAMOVITS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-498-1000
Mailing Address - Street 1:PO BOX 5268
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-5268
Mailing Address - Country:US
Mailing Address - Phone:201-498-1000
Mailing Address - Fax:
Practice Address - Street 1:170 PROSPECT AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1820
Practice Address - Country:US
Practice Address - Phone:201-498-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA55248207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW39121Medicare PIN
B39859Medicare UPIN
NJ089504Medicare PIN
NYTS0W391210Medicare PIN