Healthcare Provider Details

I. General information

NPI: 1336155027
Provider Name (Legal Business Name): CYNTHIA M SNELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2356 N FOREST RD
GETZVILLE NY
14068-1224
US

IV. Provider business mailing address

160 CONTINENTAL DR
LOCKPORT NY
14094-5224
US

V. Phone/Fax

Practice location:
  • Phone: 716-505-5630
  • Fax:
Mailing address:
  • Phone: 716-433-4703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number002348
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: