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NPI Code Detail

MEDICARE: DR. JENNIFER BETH SNIADANKO D.O.

MEDICARE: DR. JENNIFER BETH SNIADANKO D.O.
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
1208000000XPediatrics Physician005125AZ

General Provider Information

NPI Number : 1689821266
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER BETH SNIADANKO D.O.
Provider Business Mailing Address
First Line : 10713 N 124TH PL
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85259-5090
Country : US
Telephone Number : 480-993-7033
Fax Number :
Provider Business Practice Location Address
First Line : 9610 N METRO PKWY W
Second Line :
City : PHOENIX
State : AZ
Zip : 85051-1402
Country : US
Telephone Number : 623-583-3001
Fax Number : 602-314-6432
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2008
Last Update Date : 05/15/2023

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