Provider Demographics
NPI:1629094446
Name:JOEL A. SNITZER, MD
Entity Type:Organization
Organization Name:JOEL A. SNITZER, MD
Other - Org Name:SHERIDAN PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SNITZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-836-3300
Mailing Address - Street 1:605 GROVER CLEVELAND HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226
Mailing Address - Country:US
Mailing Address - Phone:716-836-3300
Mailing Address - Fax:716-836-4640
Practice Address - Street 1:605 GROVER CLEVELAND HIGHWAY
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226
Practice Address - Country:US
Practice Address - Phone:716-836-3300
Practice Address - Fax:716-836-4640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04307237Medicaid