Provider Demographics
NPI:1003035551
Name:SLADE, BRENDA DAWN (NP)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:DAWN
Last Name:SLADE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:336 RIVERSIDE DR
Mailing Address - Street 2:APT. 5A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-3422
Mailing Address - Country:US
Mailing Address - Phone:212-666-5991
Mailing Address - Fax:
Practice Address - Street 1:3009 BROADWAY
Practice Address - Street 2:BARNARD COLLEGE HEALTH SERVICE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-6905
Practice Address - Country:US
Practice Address - Phone:212-854-2091
Practice Address - Fax:212-854-2702
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF420129-1363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health