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Individual

JEROME LAWRENCE SLATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
300 MOUNT AUBURN ST, SUITE 514, CAMBRIDGE, MA 02138-5665
(617) 497-0335
(617) 492-7480
Mailing address
300 MOUNT AUBURN ST, SUITE 514, CAMBRIDGE, MA 02138-5665
(617) 497-0335
(617) 492-7480

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
38197
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0012351
NEIGHBORHOOD HEALTH PLAN
05
2043467
MA
01
26154
FALLON
01
60226
HARVARD PILGRIM
01
710593
TUFTS
01
B33479
BLUE SHIELD
Enumeration date
08/07/2006
Last updated
07/08/2007
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