Individual provider Active NPI

Patricia Slokovitz

  • Licensed Practical Nurse
  • Port Jefferson, NY
National Provider Identifier
1962534263
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
F304157 Issued in NY
Practice address
75 N Country Rd
Port Jefferson, NY 11777-2119
Phone
(631) 473-1320
Fax
(631) 474-4667
NPI assigned
Mar 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X F304157 NY
Licensed Practical Nurse 164W00000X F304157 NY Primary

Addresses

Primary practice location

75 N Country Rd
Port Jefferson, NY 11777-2119

Mailing address

625 Belle Terre Rd
Suite 100
Port Jefferson, NY 11777-2316
Phone (631) 473-1320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F304157NYMDPhysician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1962534263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 BELLE TERRE RD",
            "address_2": "SUITE 100",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772316",
            "telephone_number": "631-473-1320",
            "fax_number": "631-474-4667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 N COUNTRY RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772119",
            "telephone_number": "631-473-1320",
            "fax_number": "631-474-4667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOKOVITZ",
        "first_name": "PATRICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "F304157",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "F304157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.