Basic Information
| Provider Information | |||||||||
| NPI: | 1467828434 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SLONE | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | |||||||||
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| OtherOrganizationName: | |||||||||
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| OtherLastName: | SLONE | ||||||||
| OtherFirstName: | REBECCA | ||||||||
| OtherMiddleName: | ANN | ||||||||
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| OtherCredential: | NP | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 175 FULTON AVE | ||||||||
| Address2: | STE 500 | ||||||||
| City: | HEMPSTEAD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115503718 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6316917080 | ||||||||
| FaxNumber: | 6312066037 | ||||||||
| Practice Location | |||||||||
| Address1: | 175 FULTON AVE | ||||||||
| Address2: | STE 500 | ||||||||
| City: | HEMPSTEAD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115503718 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6316917080 | ||||||||
| FaxNumber: | 6312066037 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2015 | ||||||||
| LastUpdateDate: | 08/13/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | F401904-1 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.