Healthcare Provider Details

I. General information

NPI: 1003901158
Provider Name (Legal Business Name): JOYCE MARIE SLATER CNM, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 03/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 LARK DR WHITNEY YOUNG HEALTH CENTER, INC
ALBANY NY
12207-1300
US

IV. Provider business mailing address

PO BOX 304
SHARON SPRINGS NY
13459-0304
US

V. Phone/Fax

Practice location:
  • Phone: 518-465-4771
  • Fax: 518-462-1287
Mailing address:
  • Phone: 765-425-6592
  • Fax: 765-425-6592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberF001448-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: