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Individual

JOHN SLOBODZIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2600 WILLIAM ST, NEWFANE, NY 14108-1026
(716) 778-5071
Mailing address
PO BOX 281562, ATLANTA, GA 30384-1562
(904) 482-1070
(904) 482-1077

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
179954
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000527166001
BLUE SHIELD
NY
05
012007061/03
NY
01
930128167
RAILROAD MEDICARE
NY
Enumeration date
07/10/2006
Last updated
07/09/2007
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