MEDICARE: BROOKE SLATTERY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	114216	NY

General Provider Information

NPI Number	:	1104644731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE SLATTERY

Provider Business Mailing Address
First Line	:	31 N MAIN ST
Second Line	:
City	:	PITTSFORD
State	:	NY
Zip	:	14534-4432
Country	:	US
Telephone Number	:	585-730-2784
Fax Number	:

Provider Business Practice Location Address
First Line	:	625 PANORAMA TRL STE 210
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14625-2408
Country	:	US
Telephone Number	:	585-730-2784
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2024
Last Update Date	:	02/06/2026

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Directions to “ BROOKE SLATTERY ” Practice Location

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