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General NPI Number Information
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NPI Number | 1942687629
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Entity Type | Individual
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Provider Name | SARA M SLATKY D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/01/2015
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Last Update Date | 10/10/2019
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Provider Practice Location Address
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Address Line | 568 BROADWAY STE 304&404
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City | NEW YORK
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State | NY
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Zip | 10012-3225
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Country | US
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Telephone | 516-567-4114
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Fax |
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Provider Business Mailing Address
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Address Line | 72 PHEASANT RUN
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City | ROSLYN
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State | NY
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Zip | 11576
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Country | US
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Telephone | 516-567-4114
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 300101
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License Number State | NY
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