Provider Demographics
NPI:1568567519
Name:SLATEN, WARREN K (MD)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:K
Last Name:SLATEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 AIRPORT EXECUTIVE PARK
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-5238
Mailing Address - Country:US
Mailing Address - Phone:845-262-5313
Mailing Address - Fax:845-426-6126
Practice Address - Street 1:327 ROUTE 59
Practice Address - Street 2:
Practice Address - City:AIRMONT
Practice Address - State:NY
Practice Address - Zip Code:10952-3407
Practice Address - Country:US
Practice Address - Phone:845-356-2900
Practice Address - Fax:845-356-7797
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1754J1OtherEMPIRE BCBS (STONY POINT)
NY2799034OtherGHI PPO
NY02735055Medicaid
NY5718233OtherAETNA PPO
NY0D2414OtherHEALTHNET
NYP00328420OtherRAILROAD MEDICARE
NY1156243OtherAETNA HMO#
NY790835OtherMVP (AIRMONT/STONY POINT)
NY8557R2OtherEMPIRE BCBS (AIRMONT)
NYP3610824OtherOXFORD
NY132721370OtherTAX ID#
NY790836OtherMVP (MONROE)
NY8557R3OtherEMPIRE BCBS (MONROE)
NYP00328420OtherRAILROAD MEDICARE
NY8557R3OtherEMPIRE BCBS (MONROE)
NY0D2414OtherHEALTHNET