Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 20512 | MA |
Y | 213EG0000X | General Practice | 20512 | MA |
NPI | 1003031766 |
---|---|
Provider Name | Mariya Shnaydman |
First Address | Needham, MA 02494-1444 |
Second Address | New Bedford, MA 02745-1536 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 08/07/2007 |