Provider Demographics
NPI:1285785956
Name:SLAUGHTER, JON ZACHARY (MD)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:ZACHARY
Last Name:SLAUGHTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:493 9TH AVE
Mailing Address - Street 2:APT 5A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-4116
Mailing Address - Country:US
Mailing Address - Phone:917-696-6373
Mailing Address - Fax:
Practice Address - Street 1:99 UNIVERSITY PL
Practice Address - Street 2:4TH FLOOR, SUITE 10
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4528
Practice Address - Country:US
Practice Address - Phone:917-796-1502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2405462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry