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NPI Code Detail

MEDICARE: NATASHA SLATER LMSW, ASW

MEDICARE: NATASHA SLATER LMSW, ASW
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
1104100000XSocial Worker106778-01NY

General Provider Information

NPI Number : 1588205835
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATASHA SLATER LMSW, ASW
Provider Business Mailing Address
First Line : PO BOX 25093
Second Line :
City : BROOKLYN
State : NY
Zip : 11202-5093
Country : US
Telephone Number : 646-617-7860
Fax Number :
Provider Business Practice Location Address
First Line : 2381 HYLAN BLVD STE 13
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10306-3145
Country : US
Telephone Number : 718-494-2858
Fax Number : 718-494-5749
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2019
Last Update Date : 10/07/2019

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