Healthcare Provider Details

I. General information

NPI: 1881700243
Provider Name (Legal Business Name): ENID MARTUS SNIDMAN APRN,BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 08/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 N MAIN ST
SHARON MA
02067-1172
US

IV. Provider business mailing address

PO BOX 905
FALMOUTH MA
02541-0905
US

V. Phone/Fax

Practice location:
  • Phone: 339-364-0009
  • Fax: 781-784-3126
Mailing address:
  • Phone: 508-548-8989
  • Fax: 508-540-7094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number106418
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: