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General NPI Number Information
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NPI Number | 1841676293
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Entity Type | Organization
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Legal Business Name | SAMANTHA SLOTNICK, INC
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Dates
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Enumeration Date | 08/09/2015
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Last Update Date | 08/09/2015
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Provider Practice Location Address
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Address Line | 495 CENTRAL PARK AVE STE 301
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City | SCARSDALE
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State | NY
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Zip | 10583-1038
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Country | US
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Telephone | 914-874-1177
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Fax | 914-885-1463
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Provider Business Mailing Address
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Address Line | 495 CENTRAL PARK AVE STE 301
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City | SCARSDALE
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State | NY
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Zip | 10583-1038
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Country | US
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Telephone | 914-874-1177
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Fax | 914-885-1463
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Authorized Official
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Title or Position | OPTOMETRIST, OWNER
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Name | DR. SAMANTHA SLOTNICK
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Credential | OD, FAAO, FCOVD
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Telephone | 914-874-1118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV006820
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | TUV006820
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number | TUV006820
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 152WX0102X
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Taxonomy Name | Occupational Vision Optometrist
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License Number | TUV006820
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | TUV006820
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License Number State | NY
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