Healthcare Provider Details

I. General information

NPI: 1649653734
Provider Name (Legal Business Name): CATHY SNYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2015
Last Update Date: 07/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9520 FREDONIA STOCKTON RD
FREDONIA NY
14063-9518
US

IV. Provider business mailing address

9520 FREDONIA STOCKTON RD
FREDONIA NY
14063-9518
US

V. Phone/Fax

Practice location:
  • Phone: 716-672-3111
  • Fax:
Mailing address:
  • Phone: 716-672-3111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number016183-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: