Provider Demographics
NPI:1174764799
Name:SLAMKA, GERY JOSEPH (LPN)
Entity type:Individual
Prefix:MR
First Name:GERY
Middle Name:JOSEPH
Last Name:SLAMKA
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 BAVARIAN DR
Mailing Address - Street 2:APT. H
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-5491
Mailing Address - Country:US
Mailing Address - Phone:151-342-2319
Mailing Address - Fax:
Practice Address - Street 1:205 BAVARIAN DR
Practice Address - Street 2:APT. H
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-5491
Practice Address - Country:US
Practice Address - Phone:151-342-2319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 110612164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse