Provider Demographics
NPI:1427262799
Name:LAURENCE J. SLOSS, M.D.
Entity type:Organization
Organization Name:LAURENCE J. SLOSS, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:SLOSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-738-6878
Mailing Address - Street 1:1101 BEACON ST
Mailing Address - Street 2:STE. 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:STE. 703W
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5587
Practice Address - Country:US
Practice Address - Phone:617-738-6878
Practice Address - Fax:617-730-9915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA36075207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
25-04965OtherUHC
MAM18866OtherBCBS GROUP ID
MA2029367Medicaid
MA708600OtherTUFTS
1952376519OtherINDIVIDUAL NPI
MAA66794BWHTOtherHPHC
MAM08724OtherBCBS
MAA66794BWHTOtherHPHC
MAM18866OtherBCBS GROUP ID