1609970854 NPI number — DR. DAVID SCOTT SCHNAPP MD

Table of content: DR. DAVID SCOTT SCHNAPP MD (NPI 1609970854)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609970854 NPI number — DR. DAVID SCOTT SCHNAPP MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHNAPP
Provider First Name:
DAVID
Provider Middle Name:
SCOTT
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609970854
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/09/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 METROPOLITAN PARK DR.
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
LIVERPOOL
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13088-5842
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-870-9370
Provider Business Mailing Address Fax Number:
315-870-9364

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
192 GENESEE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13021-3361
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-258-5253
Provider Business Practice Location Address Fax Number:
315-258-0202
Provider Enumeration Date:
09/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208800000X , with the licence number:  1924291 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01639174 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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