Healthcare Provider Details

I. General information

NPI: 1437215274
Provider Name (Legal Business Name): STEPHEN HOYT SNYDER PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CENTRAL PARK WEST SUITE 1F
NEW YORK NY
10024
US

IV. Provider business mailing address

211 8TH AVE APT 4D
BROOKLYN NY
11215-2620
US

V. Phone/Fax

Practice location:
  • Phone: 212-874-0552
  • Fax:
Mailing address:
  • Phone: 718-768-0874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number010517
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: