Healthcare Provider Details

I. General information

NPI: 1568671352
Provider Name (Legal Business Name): DAVID ANDREW SNYDER L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 09/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 E WESTFIELD AVE
ROSELLE PARK NJ
07204-2084
US

IV. Provider business mailing address

110 LINVALE RD
RINGOES NJ
08551-1412
US

V. Phone/Fax

Practice location:
  • Phone: 908-447-8061
  • Fax: 908-245-6230
Mailing address:
  • Phone: 908-447-8061
  • Fax: 908-245-6230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number25MZ00044000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: