Provider Demographics
NPI:1124285192
Name:SLATE, EMILY (MD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:SLATE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:LEVINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1281 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-3544
Mailing Address - Country:US
Mailing Address - Phone:203-325-4087
Mailing Address - Fax:203-359-9941
Practice Address - Street 1:1281 E MAIN ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-3544
Practice Address - Country:US
Practice Address - Phone:203-325-4087
Practice Address - Fax:203-359-9941
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT054413207XS0106X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery