Provider Demographics
NPI:1639285794
Name:SLONE, ERIC SETH (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:SETH
Last Name:SLONE
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 1:39 BARNYARD LN
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2806
Mailing Address - Country:US
Mailing Address - Phone:516-520-5294
Mailing Address - Fax:
Practice Address - Street 1:39 BARNYARD LN
Practice Address - Street 2:
Practice Address - City:ROSLYN HTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2806
Practice Address - Country:US
Practice Address - Phone:516-520-5294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153012208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2E622OtherMEDICARE OTHER
NY2E622OtherMEDICARE OTHER
NYC07425Medicare UPIN