Provider Demographics
NPI:1902974504
Name:FRUCHTER- SLOANE, LORI (MD)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:
Last Name:FRUCHTER- SLOANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:FRUCHTER- SLOANE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:322 UNDERHILL AVE
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-4547
Mailing Address - Country:US
Mailing Address - Phone:914-962-5501
Mailing Address - Fax:914-962-0799
Practice Address - Street 1:322 UNDERHILL AVE
Practice Address - Street 2:
Practice Address - City:YORKTOWN HTS
Practice Address - State:NY
Practice Address - Zip Code:10598-4557
Practice Address - Country:US
Practice Address - Phone:914-962-5501
Practice Address - Fax:914-962-0799
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173267207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY79F55WS371OtherRAILROAD MEDICARE
NYE99390Medicare UPIN
NY79F551Medicare PIN