Healthcare Provider Details

I. General information

NPI: 1154649408
Provider Name (Legal Business Name): HASRA KHIA SNAGGS MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2010
Last Update Date: 06/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BROOKDALE PLZ
BROOKLYN NY
11212-3139
US

IV. Provider business mailing address

185 HALL ST APT 604
BROOKLYN NY
11205-5045
US

V. Phone/Fax

Practice location:
  • Phone: 718-240-5625
  • Fax:
Mailing address:
  • Phone: 917-579-4248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number627866068
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: