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General NPI Number Information
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NPI Number | 1154364990
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Entity Type | Individual
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Provider Name | TODD A SLEZAK CRNP
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Gender | Male
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 1600 WILDLIFE LODGE RD STE 1
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City | NEW KENSINGTON
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State | PA
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Zip | 15068-3652
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Country | US
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Telephone | 243-359-7337
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Fax | 243-359-7347
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Provider Business Mailing Address
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Address Line | 339 OLD HAYMAKER RD STE 209
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City | MONROEVILLE
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State | PA
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Zip | 15146-1684
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Country | US
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Telephone | 724-850-8118
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP008382
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP008382
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License Number State | PA
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