Healthcare Provider Details
I. General information
NPI: 1043148653
Provider Name (Legal Business Name): GENERATIONAL MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 CUMMINGS CTR STE 4700
BEVERLY MA
01915-6520
US
IV. Provider business mailing address
7 PARSONAGE LN
TOPSFIELD MA
01983-1312
US
V. Phone/Fax
- Phone: 978-579-2444
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JONATHAN
SNYDER
Title or Position: OWNER
Credential: MD
Phone: 508-954-8062