Healthcare Provider Details

I. General information

NPI: 1508387333
Provider Name (Legal Business Name): LYNN E SNYDER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2017
Last Update Date: 07/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3325 RTE 35
HAZLET NJ
07730-1552
US

IV. Provider business mailing address

231 OCEAN BLVD
ATLANTIC HIGHLANDS NJ
07716-1719
US

V. Phone/Fax

Practice location:
  • Phone: 732-264-5800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00377300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: