MEDICARE: AGNIESZKA B SNIOCH MD

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	207Q00000X	Family Medicine Physician	224420	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437135720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AGNIESZKA B SNIOCH MD

Provider Business Mailing Address
First Line	:	5 NEPONSET ST
Second Line	:	WOT 2ND FL, STE C203
City	:	WORCESTER
State	:	MA
Zip	:	01606-2714
Country	:	US
Telephone Number	:	978-466-3208
Fax Number	:	978-840-1680

Provider Business Practice Location Address
First Line	:	225 NEW LANCASTER RD
Second Line	:
City	:	LEOMINSTER
State	:	MA
Zip	:	01453-4958
Country	:	US
Telephone Number	:	978-466-3208
Fax Number	:	978-840-1680

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

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	12/11/2018

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