Healthcare Provider Details

I. General information

NPI: 1275592933
Provider Name (Legal Business Name): ROBERT S. SNYDER D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 10/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3594 E TREMONT AVE SUITE 210
BRONX NY
10465-2032
US

IV. Provider business mailing address

3594 E TREMONT AVE SUITE 210
BRONX NY
10465-2032
US

V. Phone/Fax

Practice location:
  • Phone: 718-792-8790
  • Fax: 718-904-8685
Mailing address:
  • Phone: 718-792-8790
  • Fax: 718-904-8685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN003289
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: