JEFFREY DAVID SNEDEKER (NPI# 1619959582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619959582 |
| Entity Type | Individual |
| Full Name | JEFFREY DAVID SNEDEKER |
| Credential | MD |
| Practice Address |
10 Graham Rd W Ithaca NY 14850-1055 |
| Practice Telephone | 6072572188 |
| Practice Fax Number | 6072667341 |
| Mailing Telephone | 6072572188 |
| Mailing Fax Number | 6072667341 |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2012-09-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 198429 | NY | Allopathic & Osteopathic Physicians |
| Y | 2080P0208X |
Pediatrics Specialization: Pediatric Infectious Diseases |
198429 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RMSCO | 161010811 | 01 | |
| COMMERCIAL CARRIERS | 161010811 | 01 | |
| AETNA MANAGED CHOICE | 4602871 | 01 | |
| NY | TOTAL CARE/MANAGED CARE | 5623 | 01 |
| TRICARE | V018315 | 01 | |
| HEALTHNOW | 000910784001 | 01 | |
| NY | 01545582 | 05 |
| Street Address |
10 GRAHAM RD W |
| City | ITHACA |
| State | NY |
| Zip Code | 14850-1055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700431376 | Caitlin C Griffin | Nurse Practitioner | 10 Graham Rd W, Ithaca, NY 14850-1055 | 2019-08-09 |
| 1871061473 | Caroline Furman | Pediatrics | 10 Graham Rd W, Ithaca, NY 14850-1055 | 2018-11-13 |
| 1376084822 | Jessica Conner | Psychologist | 10 Graham Rd W, Ithaca, NY 14850-1055 | 2017-03-16 |
| 1326596917 | Bryan H Powell | Physician Assistant | 10 Graham Rd W, Ithaca, NY 14850-1055 | 2016-09-13 |
| 1639533664 | Brian Jeffrey Kramer | Pediatrics | 10 Graham Rd W, Ithaca, NY 14850-1055 | 2016-04-06 |
| 1528476629 | Katherine Rudert | Nurse Practitioner | 10 Graham Rd W, Ithaca, NY 14850-1055 | 2014-08-01 |
| 1548689920 | Brittany J Raffa | Pediatrics | 10 Graham Rd W, Ithaca, NY 14850-1055 | 2014-04-14 |
| 1558628255 | Lindsay Brianne Tamborelle | Pediatrics | 10 Graham Rd W, Ithaca, NY 14850-1055 | 2012-04-19 |
| 1548527344 | Nina E Pegram | Nurse Practitioner | 10 Graham Rd W, Ithaca, NY 14850-1055 | 2012-04-18 |
| 1871741314 | Marisa C Matsudaira | Social Worker | 10 Graham Rd W, Ithaca, NY 14850-1055 | 2008-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174123897 | Michelle Lee Sanito | Registered Nurse | 400 Lake Street, Ithaca, NY 14850 | 2020-10-30 |
| 1457959843 | Summit Alternatives Lmsw PC | Community/Behavioral Health | 215 North Cayuga Street, 2nd Floor Business Complex, Ithaca, NY 14850 | 2020-10-16 |
| 1518581701 | Sameer Acharya | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency, Cayuga Medical Center, 101 Dates Drive, Ithaca, NY 14850 | 2020-06-03 |
| 1699399873 | Anurag Aryal | Student in an Organized Health Care Education/Training Program | 101 Dates Drive Internal Medicine Residency, Cayuga Med, Ithaca, NY 14850 | 2020-06-03 |
| 1932723228 | Binay Kumar Kshetree | Student in an Organized Health Care Education/Training Program | Cayuga Medical Center, 101 Dates Drive, Ithaca, NY 14850 | 2020-06-02 |
| 1225657349 | Nima Hazrati Pour Fard | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency Cayuga Medical Center, 101, Ithaca, NY 14850 | 2020-04-09 |
| 1326671090 | Garret Hoskey | Specialist/Technologist | 953 Dany Road, Ithaca, NY 14850 | 2020-02-20 |
| 1609407709 | En-ting Hsu | Marriage & Family Therapist | 110 N. Cayuga Street 4th Floor Suite 3, Ithaca, NY 14850 | 2020-01-28 |
| 1306491063 | Patrick Owen Mckeon | Specialist/Technologist | Hill Center G66, 953 South Danby Rd., Ithaca, NY 14850 | 2019-08-08 |
| 1538722343 | Priyesh Thakurathi | Student in an Organized Health Care Education/Training Program | 101 Dates Drive Cayuga Medical Center, Internal Medicine Residency Program, Ithaca, NY 14850 | 2019-04-17 |
| Find all providers in zip 14850 | ||||
| Taxonomy Code | 2080P0208X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Infectious Diseases |
| A pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases and complex or investigational treatments. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306222682 | Paul Jeffrey Edelson | Pediatrics | Jfk Intl Airport-terminal4, Rm.219.016, Cdc Quarantine Station, Jamaica, NY 11430 | 2015-08-10 |
| 1861897761 | Natalie Banniettis | Pediatrics | 921 Avenue O, Brooklyn, NY 11230-6508 | 2014-11-04 |
| 1700289303 | Carine Hedari | Pediatrics | 430 East 29th Street, Division of Pediatric Infectious Diseases, New York, NY 10016 | 2014-09-27 |
| 1811335052 | Brooklyn Pediatric Infectious Diseased PC | Pediatrics | 433 74th Street, Brooklyn, NY 11209 | 2013-06-10 |
| 1568808814 | Quoc Van Nguyen | Pediatrics | 4810 Palmer Rd, Manlius, NY 13104-9348 | 2013-05-14 |
| 1922343573 | John Michael Zahradnik | Pediatrics | 25 Gregory Dr, Goshen, NY 10924-1016 | 2012-12-09 |
| 1386970424 | Joy H. Glaser | Pediatrics | 1 Windcrest Rd, Rye, NY 10580-1625 | 2009-10-25 |
| 1972837292 | Asif Noor | Pediatrics | 120 Mineola Blvd Ste 210, Mineola, NY 11501-4077 | 2009-09-21 |
| 1013178920 | Christy Anne Beneri | Pediatrics | Hsc Suny Stony Brook, Department of Pediatrics Hsc T-11, Stony Brook, NY 11794-8111 | 2008-06-23 |
| 1770656019 | Lorry Rubin | Pediatrics | Lijmc -pediatrics, 269-01 76th Avenue, New Hyde Park, NY 11040 | 2006-11-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.