Healthcare Provider Details

I. General information

NPI: 1740692706
Provider Name (Legal Business Name): ABIGAIL SNYDER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2014
Last Update Date: 10/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 E 17TH ST # 724
NEW YORK NY
10003-1901
US

IV. Provider business mailing address

22 E 17TH ST # 724
NEW YORK NY
10003-1901
US

V. Phone/Fax

Practice location:
  • Phone: 347-368-7056
  • Fax:
Mailing address:
  • Phone: 347-368-7056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number073216-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: