Healthcare Provider Details

I. General information

NPI: 1679547871
Provider Name (Legal Business Name): STEPHEN E SNYDER P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 01/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 CENTRAL AVE
DUNKIRK NY
14048-2114
US

IV. Provider business mailing address

166 E 4TH ST
DUNKIRK NY
14048-2226
US

V. Phone/Fax

Practice location:
  • Phone: 716-366-2122
  • Fax: 716-363-1235
Mailing address:
  • Phone: 716-206-6474
  • Fax: 716-363-1235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number006791
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: