Provider Demographics
NPI:1023996717
Name:SLATTERY, ELLEN D
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:D
Last Name:SLATTERY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:D
Other - Last Name:GREGUSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:97 ELLENSUE DR
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-1008
Mailing Address - Country:US
Mailing Address - Phone:631-942-4360
Mailing Address - Fax:
Practice Address - Street 1:97 ELLENSUE DR
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-1008
Practice Address - Country:US
Practice Address - Phone:631-942-4360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278E1000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedEducational