Healthcare Provider Details

I. General information

NPI: 1659893212
Provider Name (Legal Business Name): ALEXANDRA COMPTON SNYDER AGPCNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2017
Last Update Date: 07/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 EAST 68TH STREET
NEW YORK NY
10065
US

IV. Provider business mailing address

525 E 68TH ST
NEW YORK NY
10065-4870
US

V. Phone/Fax

Practice location:
  • Phone: 215-850-2491
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number308173
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: