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General NPI Number Information
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NPI Number | 1285785956
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Entity Type | Individual
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Provider Name | JON ZACHARY SLAUGHTER M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 10/03/2008
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Provider Practice Location Address
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Address Line | 99 UNIVERSITY PL 4TH FLOOR, SUITE 10
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City | NEW YORK
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State | NY
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Zip | 10003-4528
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Country | US
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Telephone | 917-796-1502
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Fax |
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Provider Business Mailing Address
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Address Line | 493 9TH AVE APT 5A
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City | NEW YORK
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State | NY
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Zip | 10018-4116
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Country | US
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Telephone | 917-696-6373
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 240546
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License Number State | NY
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