Provider Demographics
NPI:1679221212
Name:SLAVIN, ERIKA (PA)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:SLAVIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 GARFIELD PL
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-7056
Mailing Address - Country:US
Mailing Address - Phone:347-288-9192
Mailing Address - Fax:
Practice Address - Street 1:175 E MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2981
Practice Address - Country:US
Practice Address - Phone:631-549-5700
Practice Address - Fax:631-549-1991
Is Sole Proprietor?:No
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028100363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant