Healthcare Provider Details

I. General information

NPI: 1528306362
Provider Name (Legal Business Name): KERRY MARIE SNYDER-TORRES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2013
Last Update Date: 01/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 ROSELAWN CRES
FAIRPORT NY
14450-1326
US

IV. Provider business mailing address

142 ROSELAWN CRES
FAIRPORT NY
14450-1326
US

V. Phone/Fax

Practice location:
  • Phone: 585-489-2427
  • Fax:
Mailing address:
  • Phone: 585-489-2427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number659882-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: