Provider Demographics
NPI:1386868917
Name:SLUTSKY, RICHARD ELLIOT
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ELLIOT
Last Name:SLUTSKY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 PARK ST
Mailing Address - Street 2:OFFICE 201
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-3814
Mailing Address - Country:US
Mailing Address - Phone:914-737-1911
Mailing Address - Fax:914-737-1943
Practice Address - Street 1:1019 PARK ST
Practice Address - Street 2:OFFICE 201
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-3814
Practice Address - Country:US
Practice Address - Phone:914-737-1911
Practice Address - Fax:914-737-1943
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034609-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist