Healthcare Provider Details

I. General information

NPI: 1982906053
Provider Name (Legal Business Name): AMY HELENE SNYDER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY HELENE BOLCER

II. Dates (important events)

Enumeration Date: 11/23/2010
Last Update Date: 09/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 HARRISON AVE FL 5 MOAKLEY, 3RD FLOOR
BOSTON MA
02118-2905
US

IV. Provider business mailing address

720 HARRISON AVE DOB 503
BOSTON MA
02118
US

V. Phone/Fax

Practice location:
  • Phone: 617-638-8446
  • Fax: 617-638-5756
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN282518
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: