Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 294675 | NY |
N | 207VG0400X | Gynecologist | 294675 | NY |
N | 207VX0000X | Obstetrician | 294675 | NY |
NPI | 1023428455 |
---|---|
Provider Name | Jennifer Slagus |
First Address | Westbury, NY 11590-5114 |
Second Address | Smithtown, NY 11787-1448 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2014 |
Last Update Date | 03/12/2019 |