Healthcare Provider Details

I. General information

NPI: 1003106444
Provider Name (Legal Business Name): JASON CHARLES SNYDER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2011
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 W 125TH ST FL 2
NEW YORK NY
10027-4426
US

IV. Provider business mailing address

55 WATER ST FL 2
NEW YORK NY
10041-0010
US

V. Phone/Fax

Practice location:
  • Phone: 212-491-2400
  • Fax: 212-491-2401
Mailing address:
  • Phone: 646-680-2888
  • Fax: 516-542-5556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number006497
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: