MEDICARE: MARY SLEZAK RN

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	163W00000X	Registered Nurse	818445	NY

General Provider Information

NPI Number	:	1245197953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY SLEZAK RN

Provider Business Mailing Address
First Line	:	400 PATROON CREEK BLVD STE 211
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12206-5012
Country	:	US
Telephone Number	:	518-801-0725
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 PATROON CREEK BLVD STE 211
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12206-5012
Country	:	US
Telephone Number	:	518-801-0725
Fax Number	:

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

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/06/2026

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