Healthcare Provider Details

I. General information

NPI: 1144292400
Provider Name (Legal Business Name): JODY SNYDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 FARBER HALL
BUFFALO NY
14214-8001
US

IV. Provider business mailing address

160 FARBER HALL
BUFFALO NY
14214-8001
US

V. Phone/Fax

Practice location:
  • Phone: 716-689-1901
  • Fax:
Mailing address:
  • Phone: 716-689-1901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number168612-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: