Provider Demographics
NPI:1871631911
Name:SLOCUM, NANCY E (DC)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:E
Last Name:SLOCUM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:NANCY
Other - Middle Name:ELIZABETH
Other - Last Name:SLOCUM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:2122 CARTER-SLOCUM RD
Mailing Address - Street 2:
Mailing Address - City:MARATHON
Mailing Address - State:NY
Mailing Address - Zip Code:13803
Mailing Address - Country:US
Mailing Address - Phone:607-423-1567
Mailing Address - Fax:
Practice Address - Street 1:75 EAST COURT ST
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045
Practice Address - Country:US
Practice Address - Phone:607-423-1567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0084521111N00000X
NY008452111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCO8452-7OtherWORKERS' COMP. BOARD
NYCO84527OtherWORKERS COMP BOARD AUTH #
NYCO84527OtherWORKERS COMP BOARD AUTH #
NY56558BMedicare UPIN