Individual
JEFFREY DAVID SNEDEKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10 GRAHAM RD W, ITHACA, NY 14850-1055
(607) 257-2188
(607) 266-7341
Mailing address
10 GRAHAM RD W, ITHACA, NY 14850-1055
(607) 257-2188
(607) 266-7341
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
198429
NY
2080P0208X
Pediatric Infectious Diseases Physician
Primary
198429
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000910784001
HEALTHNOW
—
05
—
01545582
—
NY
01
—
161010811
COMMERCIAL CARRIERS
—
01
—
4602871
AETNA MANAGED CHOICE
—
01
—
5623
TOTAL CARE/MANAGED CARE
NY
01
—
V018315
TRICARE
—
Enumeration date
11/16/2005
Last updated
09/18/2012
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