Individual
MICHAEL SLATTERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8 BRENTWOOD DR, ITHACA, NY 14850-1871
(607) 273-6757
(607) 273-2854
Mailing address
821 CLIFF ST, ITHACA, NY 14850-2097
(607) 277-2365
(607) 277-1415
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
220740
NY
2084N0600X
Clinical Neurophysiology Physician
220740
NY
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
Primary
220740
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02136987
—
NY
Enumeration date
08/09/2005
Last updated
06/08/2012
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