Provider Demographics
NPI:1427396621
Name:SLAYBACK HEALTH LLC
Entity Type:Organization
Organization Name:SLAYBACK HEALTH LLC
Other - Org Name:SLAYBACK HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NIRMALA
Authorized Official - Middle Name:
Authorized Official - Last Name:RANGANATHAN CHETTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-533-2468
Mailing Address - Street 1:37 SLAYBACK DR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-1915
Mailing Address - Country:US
Mailing Address - Phone:917-533-2468
Mailing Address - Fax:
Practice Address - Street 1:37 SLAYBACK DR
Practice Address - Street 2:
Practice Address - City:PRINCETON JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08550-1915
Practice Address - Country:US
Practice Address - Phone:917-533-2468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty