MEDICARE: MAUREEN REBECCA SLATTERY 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	207V00000X	Obstetrics & Gynecology Physician	243335	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427067974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUREEN REBECCA SLATTERY MD

Provider Business Mailing Address
First Line	:	995 SENATOR KEATING BLVD STE 210
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-2776
Country	:	US
Telephone Number	:	585-368-4455
Fax Number	:	585-271-3688

Provider Business Practice Location Address
First Line	:	995 SENATOR KEATING BLVD STE 210
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-2776
Country	:	US
Telephone Number	:	585-368-4455
Fax Number	:	585-271-3688

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

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	03/25/2019

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