Healthcare Provider Details

I. General information

NPI: 1225804263
Provider Name (Legal Business Name): EMILIA SLABINSKI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2023
Last Update Date: 02/05/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 NEW PARK AVE
NORTH FRANKLIN CT
06254-1807
US

IV. Provider business mailing address

1150 S MAIN ST APT 111
MIDDLETOWN CT
06457-5039
US

V. Phone/Fax

Practice location:
  • Phone: 860-889-7345
  • Fax:
Mailing address:
  • Phone: 908-907-7822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number6388
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number6388
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: