Individual
EDWIN SLATER JR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4 BURTON AVE APT 2, BOSTON, MA 02119-2364
(857) 302-8140
Mailing address
4 BURTON AVE APT 2, BOSTON, MA 02119-2364
(857) 302-8140
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10021970726
—
MA
Enumeration date
11/07/2022
Last updated
11/07/2022
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