Jacqueline Ms Sloan, MD
Individual provider Active NPI Pediatrics Physician · Weatogue, CT
NPI 1902803299 · NPPES record last updated Jul 29, 2011
Key facts
- NPI
- 1902803299
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 045826 (CT)
- Practice address
- 225 Hopmeadow Street
Weatogue, CT 06089 - Phone
- (860) 658-0465
- NPI assigned
- Jul 1, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 045826 | CT | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Affiliates of Cape Cod, Inc. | Pediatrics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 045826 | CT | Yes |
Addresses
Primary practice location
225 Hopmeadow Street
Weatogue, CT 06089
Mailing address
46 Great Pond Rd
Simsbury, CT 06070-1904
Other names
- Jacqueline M Shafto
Other providers in Weatogue, CT
- Michael B. Schneider
- Darcie Lynn Schwab
- Serene Solutions, LLC
- Breanne Sills
- Simsbury Pediatric & Adolescent Dentistry, LLC
- Julianne Kelley Smith
- Courtney Lynne Souza
- Daniel L Spada
- Marissa Lynn Stafford
- Russell Stone
All providers in Weatogue, CT · Pediatrics Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.