Healthcare Provider Details

I. General information

NPI: 1528986106
Provider Name (Legal Business Name): LACEY A SNYDER-MELENDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 FARMEDGE RD
LEVITTOWN NY
11756-5202
US

IV. Provider business mailing address

92 SHEFFIELD AVE
WEST BABYLON NY
11704-5208
US

V. Phone/Fax

Practice location:
  • Phone: 516-490-3301
  • Fax:
Mailing address:
  • Phone: 631-839-3165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: