Provider Demographics
NPI:1689717712
Name:SLAMOVITS, THOMAS L (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:L
Last Name:SLAMOVITS
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 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:201-841-1031
Mailing Address - Fax:
Practice Address - Street 1:200 S BROAD ST
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-5003
Practice Address - Country:US
Practice Address - Phone:201-841-1031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1753091207W00000X
NJMA 55248207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ089504Medicare ID - Type Unspecified
NJG85365T2NMedicare PIN
B39895Medicare UPIN
NYTS0W391210Medicare ID - Type Unspecified
NY29E401Medicare PIN