MEDICARE: CHARLOTTE K SLAVICK MD

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1306780556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLOTTE K SLAVICK MD

Provider Business Mailing Address
First Line	:	98 PRESIDENT AVE
Second Line	:
City	:	LAVALLETTE
State	:	NJ
Zip	:	08735-2150
Country	:	US
Telephone Number	:	732-567-4022
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 STATION PLZ N STE 509
Second Line	:
City	:	MINEOLA
State	:	NY
Zip	:	11501-3893
Country	:	US
Telephone Number	:	516-663-2501
Fax Number	:

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

Provider Enumeration Date	:	04/17/2026
Last Update Date	:	04/17/2026

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