Healthcare Provider Details
I. General information
NPI: 1760659429
Provider Name (Legal Business Name): ADAM E SNIDERMAN VMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/13/2008
Last Update Date: 05/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
133 E PALISADE AVE UNIT H
ENGLEWOOD NJ
07631-2273
US
IV. Provider business mailing address
133 E PALISADE AVE UNIT H
ENGLEWOOD NJ
07631
US
V. Phone/Fax
- Phone: 201-450-4291
- Fax: 973-895-4948
- Phone: 201-450-4291
- Fax: 973-895-4948
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174M00000X |
| Taxonomy | Veterinarian |
| License Number | 29VI00480900 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: