Provider Demographics
NPI:1265405575
Name:DAVE, SNEHLATA V (MD)
Entity type:Individual
Prefix:
First Name:SNEHLATA
Middle Name:V
Last Name:DAVE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:585 597 MERRIMACK STREET
Mailing Address - Street 2:LOWELL COMMUNITY HEALTH CENTER
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854
Mailing Address - Country:US
Mailing Address - Phone:978-937-9700
Mailing Address - Fax:978-446-9830
Practice Address - Street 1:597 MERRIMACK STREET
Practice Address - Street 2:LOWELL COMMUNITY HEALTH CENTER
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854
Practice Address - Country:US
Practice Address - Phone:978-937-9700
Practice Address - Fax:978-446-9830
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA56557208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
042881348OtherONE HEALTH
001262OtherNEIGHBORHOOD HEALTH PLAN
042881348OtherBEECH STREET
042881348OtherUNICARE
204780OtherHARVARD PILGRIM HEALTH CA
3073602OtherAETNA
731686OtherTUFTS
J06598OtherBLUE CROSS BLUE SHIELD
MAJ0659801OtherMEDICARE PTAN
1203911OtherUNITED HEALTH CARE
MA1305557Medicaid
33802OtherFALLON
72268OtherCIGNA
979893OtherNETWORK HEALTH
042881348OtherCHOICECARE
3073602OtherAETNA
MAJ06598Medicare ID - Type Unspecified