Provider Demographics
NPI:1467461087
Name:SLESAR, IRVING
Entity Type:Individual
Prefix:DR
First Name:IRVING
Middle Name:
Last Name:SLESAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:IRVING
Other - Middle Name:
Other - Last Name:SLESAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:4 W 101ST ST APT 69
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-4716
Mailing Address - Country:US
Mailing Address - Phone:646-342-8891
Mailing Address - Fax:
Practice Address - Street 1:4 W 101ST ST APT 69
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-4716
Practice Address - Country:US
Practice Address - Phone:646-342-8891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002502101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health