Basic Information
Provider Information
NPI: 1922364785
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SLOANE
FirstName: AMY
MiddleName: JOHNSON
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: JOHNSON
OtherFirstName: AMY
OtherMiddleName:  
OtherNamePrefix: MS.
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 191
Address2:  
City: ROCKLAND
State: DE
PostalCode: 197320191
CountryCode: US
TelephoneNumber: 6026516212
FaxNumber: 6026514945
Practice Location
Address1: 509 N BROAD ST
Address2: INSPIRA MEDICAL CENTER WOODBURY
City: WOODBURY
State: NJ
PostalCode: 080961617
CountryCode: US
TelephoneNumber: 8568450100
FaxNumber: 3026515954
Other Information
ProviderEnumerationDate: 04/05/2012
LastUpdateDate: 09/20/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X25MA09696100NJY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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