Healthcare Provider Details

I. General information

NPI: 1639541311
Provider Name (Legal Business Name): DEEANN NANCY SNYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2015
Last Update Date: 10/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 PRIMROSE LN
CHESTER NY
10918
US

IV. Provider business mailing address

16 PRIMROSE LN
CHESTER NY
10918
US

V. Phone/Fax

Practice location:
  • Phone: 914-373-0813
  • Fax:
Mailing address:
  • Phone: 914-373-0813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: