Provider Demographics
NPI:1811967110
Name:STEIN SLOANE MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:STEIN SLOANE MEDICAL ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:SLOANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-537-7695
Mailing Address - Street 1:1331 E WYOMING AVE
Mailing Address - Street 2:SUITE 2160
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19124-3808
Mailing Address - Country:US
Mailing Address - Phone:215-537-7695
Mailing Address - Fax:215-537-7001
Practice Address - Street 1:1331 E WYOMING AVE
Practice Address - Street 2:SUITE 2160
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19124-3808
Practice Address - Country:US
Practice Address - Phone:215-537-7695
Practice Address - Fax:215-537-7001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029921E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012075170002Medicaid
PA052954Medicare ID - Type Unspecified