Provider Demographics
NPI:1922363472
Name:HARRY SNADY MD PHD PC
Entity Type:Organization
Organization Name:HARRY SNADY MD PHD PC
Other - Org Name:GASTROCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:SNADY
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:201-348-9200
Mailing Address - Street 1:22 E 88TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0509
Mailing Address - Country:US
Mailing Address - Phone:212-831-0700
Mailing Address - Fax:
Practice Address - Street 1:1 BELLEVUE TER
Practice Address - Street 2:
Practice Address - City:WEEHAWKEN
Practice Address - State:NJ
Practice Address - Zip Code:07086-6901
Practice Address - Country:US
Practice Address - Phone:201-348-9200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03842900207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ100013263Medicare PIN
NJ009075Medicare PIN