Individual
MR. ADAM WILLIAM SLEVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
419 PARK AVE S RM 1305, NEW YORK, NY 10016-8433
(212) 545-5400
Mailing address
524 E 20TH ST, APT 9G, NEW YORK, NY 10009-1302
(215) 313-8800
(212) 263-0402
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA052844
PA
363AS0400X
Surgical Physician Assistant
MA052844
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013351
STATE LICENSE
NY
01
—
1073589
BOARD CERTIFICATION (NCCPA)#
PA
01
—
MA052844
STATE LICENSE#
PA
Enumeration date
06/02/2008
Last updated
04/02/2021
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