Basic Information
| Provider Information | |||||||||
| NPI: | 1164471686 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SLEAVIN | ||||||||
| FirstName: | HAROLD | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 23674 | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 071890001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322640700 | ||||||||
| FaxNumber: | 7322641414 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 BETHANY RD | ||||||||
| Address2: | BUILDING 5;SUITE 65 | ||||||||
| City: | HAZLET | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077301663 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322640700 | ||||||||
| FaxNumber: | 7322641414 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 25MA04944700 | NJ | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.