Healthcare Provider Details

I. General information

NPI: 1144959974
Provider Name (Legal Business Name): LAURA SNYDER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2022
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 CORNELL RD STE 2
LATHAM NY
12110-1425
US

IV. Provider business mailing address

51 PINEWOOD AVE
ALBANY NY
12208-2711
US

V. Phone/Fax

Practice location:
  • Phone: 518-348-3176
  • Fax: 844-574-2616
Mailing address:
  • Phone: 518-764-2342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number347998
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: