Healthcare Provider Details

I. General information

NPI: 1588641328
Provider Name (Legal Business Name): LORY SNADY-MCCOY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 05/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E MANNING ST
PROVIDENCE RI
02906-5109
US

IV. Provider business mailing address

150 E MANNING ST
PROVIDENCE RI
02906-5109
US

V. Phone/Fax

Practice location:
  • Phone: 401-272-2020
  • Fax: 401-421-5979
Mailing address:
  • Phone: 401-272-2020
  • Fax: 401-421-5979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD07778
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: