Provider Demographics
NPI:1437246634
Name:IRIS R SLATER MD PC
Entity Type:Organization
Organization Name:IRIS R SLATER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:SLATER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-988-5165
Mailing Address - Street 1:245 A EAST 61ST STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-8203
Mailing Address - Country:US
Mailing Address - Phone:212-988-5165
Mailing Address - Fax:212-371-0650
Practice Address - Street 1:245 A EAST 61 ST STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-8203
Practice Address - Country:US
Practice Address - Phone:212-988-5165
Practice Address - Fax:212-371-0650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0881801207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00139304Medicaid
B14188Medicare UPIN
NY00139304Medicaid