Johnny Slade, MD is a
Emergency Medicine physician based in East Setauket, New York. Johnny Slade is licensed to practice in New York (license number 176120) and his current practice location is 11 Bridge Rd, East Setauket, New York. He can be reached at his office (for appointments etc.) via phone at
(631) 476-4000.
NPI number for Johnny Slade is 1295392553 and his current mailing address is 11 Bridge Rd, East Setauket, New York. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1295392553.
Physician's Profile
| Full Name | Johnny Slade |
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| Gender | Male |
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| Speciality | Emergency Medicine |
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| Location | 11 Bridge Rd, East Setauket, New York |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1295392553
- Provider Enumeration Date: 05/22/2019
- Last Update Date: 05/22/2019
Medical Identifiers
Medical identifiers for Johnny Slade such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1295392553 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | 176120 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Johnny Slade is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Johnny Slade, MD
11 Bridge Rd,
East Setauket, NY 11733
Ph: (631) 476-4000 | Johnny Slade, MD
11 Bridge Rd,
East Setauket, NY 11733
Ph: (631) 476-4000 |
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