Basic Information
| Provider Information | |||||||||
| NPI: | 1396723714 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SLOAN | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | BRETT | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21 SOUTH ROAD | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060326231 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606794600 | ||||||||
| FaxNumber: | 8606793207 | ||||||||
| Practice Location | |||||||||
| Address1: | 21 SOUTH ROAD | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060326231 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606794600 | ||||||||
| FaxNumber: | 8606793207 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2006 | ||||||||
| LastUpdateDate: | 06/15/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 045584 | CT | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.