Provider Demographics
NPI:1558435883
Name:SLOANE, LARRY J (MD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:J
Last Name:SLOANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:87 COLD SPRING RD
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-3142
Mailing Address - Country:US
Mailing Address - Phone:631-385-1288
Mailing Address - Fax:631-547-6471
Practice Address - Street 1:87 COLD SPRING RD
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-3142
Practice Address - Country:US
Practice Address - Phone:631-385-1288
Practice Address - Fax:631-547-6471
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY15375312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
0457966OtherUHC AETNA
153753OtherHIP NO 1 LICENSE
1563156OtherTHE MAIL HANDLERS BENEFIT
NY00832191Medicaid
0004335699OtherAETNA
1500156OtherUHC UBH UNITED BEHAVIORAL
18D56OtherEMPIRE BCBS
260013890OtherPALMETTA GBA RAILROAD MED
AS1563OtherOXFORD HEALTH PLANS
NY153753OtherMUTUAL OF OMAHA
AS1563OtherOXFORD HEALTH PLANS
1500156OtherUHC UBH UNITED BEHAVIORAL