Provider Demographics
NPI:1154552453
Name:SLATE, KAREN L (OD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:L
Last Name:SLATE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:L
Other - Last Name:HEANEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1801 ROCKLAND RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-3648
Mailing Address - Country:US
Mailing Address - Phone:302-651-4413
Mailing Address - Fax:302-651-4445
Practice Address - Street 1:101 WELLNESS WAY
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-4366
Practice Address - Country:US
Practice Address - Phone:302-424-5420
Practice Address - Fax:302-424-5426
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEI30011427152W00000X
PAOEG002275152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE250592502Medicaid
DE250592502Medicaid
PANON PAROtherDAVIS VISION
PAOEG002275OtherLOOMIS
PAOEG002275OtherHUMANA
PA50088577OtherCAPITAL BLUE CROSS/KHPC
PA54384004OtherDAVIS AFFINITY
PA50088577OtherKEYSTONE/SENIOR BLUE
PAHE2113397OtherHIGHMARK/PPO BLUE
PA3729764000OtherINDEPENDENCE
PA50088577OtherCAPITAL BLUE CROSS
PAOEG002275OtherCORESOURCE
PAOEG002275OtherBERKSHIRE HEALTH
PA3729764000OtherINDEPENDENCE PERSONAL CHOICE
PA50088577OtherCAPITAL BLUE CROSS/POS
PAHE2113397OtherHIGHMARK BLUE SHIELD
PAHE2113397OtherHIGHMARK/FREEDOM
PAHE2113397OtherHIGHMARK/CLASSIC BLUE
PA50088577OtherCAPITAL BLUE CROSS/TRADITIONAL/PPO
PA1154552453OtherAMERIHEALTH/HMO
PA3729764000OtherKEYSTONE EAST
PA50088577OtherKEYSTONE/CBC
PA50088577OtherCAPITAL BLUE CROSS/SB PPO
PA50088577OtherCAPITAL BLUE CROSS/SENIOR BLUE
PAHE2113397OtherHIGHMARK/PPO BLUE