MEDICARE: DR. HARRY SNADY MD PHD, FACG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	135601-1	NY
2	207RG0100X	Gastroenterology Physician	25MA03842900	NJ

General Provider Information

NPI Number	:	1144322801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARRY SNADY MD PHD, FACG

Provider Business Mailing Address
First Line	:	22 EAST 88TH STREET
Second Line	:	ADMINISTRATIVE AND PRIMARY OFFICE
City	:	NEW YORK
State	:	NY
Zip	:	10128
Country	:	US
Telephone Number	:	212-831-0700
Fax Number	:	212-410-6093

Provider Business Practice Location Address
First Line	:	5600 KENNEDY BLVD W
Second Line	:	SUITE 103
City	:	WEST NEW YORK
State	:	NJ
Zip	:	07093-1256
Country	:	US
Telephone Number	:	201-902-9500
Fax Number	:	201-902-9502

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2006
Last Update Date	:	02/05/2013

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