Provider Demographics
NPI:1801050117
Name:SHNAIDMAN, CLARA (MD)
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:
Last Name:SHNAIDMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:99 E STATE ST
Mailing Address - Street 2:PO BOX1250
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-1203
Mailing Address - Country:US
Mailing Address - Phone:518-883-8620
Mailing Address - Fax:518-883-5653
Practice Address - Street 1:4104 STATE HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-6202
Practice Address - Country:US
Practice Address - Phone:518-883-8620
Practice Address - Fax:518-883-5653
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2015-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY247590207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03068336Medicaid
NY10400487OtherCDPHP
NY6022479OtherMVP HEALTHCARE
NY000418266001OtherBSH NE NY
NY6022479OtherMVP HEALTHCARE