Provider Demographics
NPI:1629178967
Name:SLAVIN, EILEEN A (DNP)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:A
Last Name:SLAVIN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 PROVIDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:NISKAYUNA
Mailing Address - State:NY
Mailing Address - Zip Code:12309-3923
Mailing Address - Country:US
Mailing Address - Phone:518-374-2212
Mailing Address - Fax:518-374-4330
Practice Address - Street 1:1805 PROVIDENCE AVE
Practice Address - Street 2:PATHWAYS NURSING AND REHABILITATION
Practice Address - City:NISKAYUNA
Practice Address - State:NY
Practice Address - Zip Code:12309-3923
Practice Address - Country:US
Practice Address - Phone:518-374-2212
Practice Address - Fax:518-374-4330
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF334412363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ35461Medicare UPIN
NY0945G1Medicare ID - Type UnspecifiedMEDICARE