Provider Demographics
NPI:1952376519
Name:SLOSS, LAURENCE J (MD)
Entity Type:Individual
Prefix:
First Name:LAURENCE
Middle Name:J
Last Name:SLOSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 BEACON ST
Mailing Address - Street 2:SUITE 703W
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5587
Mailing Address - Country:US
Mailing Address - Phone:617-738-6878
Mailing Address - Fax:617-730-9915
Practice Address - Street 1:1101 BEACON ST
Practice Address - Street 2:SUITE 703W
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5539
Practice Address - Country:US
Practice Address - Phone:617-738-6878
Practice Address - Fax:617-730-9915
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA36075207RC0000X, 207R00000X, 2080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM08724OtherBC/BS
MA2029367Medicaid
MAM08724OtherBC/BS
A66794Medicare UPIN
MAM08724OtherBC/BS