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General NPI Number Information
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NPI Number | 1568444651
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Entity Type | Individual
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Provider Name | JARMILA SLEZKOVA M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 05/15/2012
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Provider Practice Location Address
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Address Line | 830 WASHINGTON ST
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City | WATERTOWN
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State | NY
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Zip | 13601-4034
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Country | US
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Telephone | 315-785-8509
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Fax | 315-785-8619
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Provider Business Mailing Address
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Address Line | PO BOX 91
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City | WATERTOWN
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State | NY
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Zip | 13601-0091
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Country | US
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Telephone | 315-782-4207
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Fax | 315-782-8699
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 002048
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License Number State | NY
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