Provider Demographics
NPI:1922602010
Name:SLOAN, MARLENA MARTHA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARLENA
Middle Name:MARTHA
Last Name:SLOAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12182-3029
Mailing Address - Country:US
Mailing Address - Phone:518-496-3113
Mailing Address - Fax:
Practice Address - Street 1:362 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1804
Practice Address - Country:US
Practice Address - Phone:413-528-2860
Practice Address - Fax:413-528-4588
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH239445183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist