Individual
JOSEPH M SLATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1353 BOSTON POST RD, MADISON, CT 06443-3445
(203) 245-4933
(203) 245-4399
Mailing address
1353 BOSTON POST RD, MADISON, CT 06443-3445
(203) 245-4933
(203) 245-4399
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000090
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290000090CT01
ANTHEM BC/BS
CT
01
—
706112
CONNECTICARE
CT
Enumeration date
09/13/2006
Last updated
07/08/2007
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