Provider Demographics
NPI:1598912610
Name:SNEJNEVSKI, PAVEL B (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAVEL
Middle Name:B
Last Name:SNEJNEVSKI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3014 Q ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-3080
Mailing Address - Country:US
Mailing Address - Phone:202-965-6564
Mailing Address - Fax:
Practice Address - Street 1:3014 Q ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-3080
Practice Address - Country:US
Practice Address - Phone:202-965-6564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1764103T00000X
VA0810002613103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC850554Medicare PIN