MEDICARE: ILANA SLAFF MEDICAL PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1134693740
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ILANA SLAFF MEDICAL PLLC

Provider Business Mailing Address
First Line	:	7929 213TH ST
Second Line	:
City	:	OAKLAND GARDENS
State	:	NY
Zip	:	11364-3507
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	COUNSELING & PSYCHOTHERAPY THROGGS NECK
Second Line	:	3612 EAST TREMONT AVENUE, LOWER LEVEL
City	:	BRONX
State	:	NY
Zip	:	10465-1046
Country	:	US
Telephone Number	:	718-792-4178
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ILANA M SLAFF-GALATAN
Credential	:	MD
Telephone Number	:	917-613-2387

Provider Enumeration Date	:	01/16/2019
Last Update Date	:	01/16/2019

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