Healthcare Provider Details

I. General information

NPI: 1396386132
Provider Name (Legal Business Name): LITTLE BUDDIES CHILD NEUROLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2019
Last Update Date: 10/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1655 ELMWOOD AVE STE 222
ROCHESTER NY
14620-3426
US

IV. Provider business mailing address

1655 ELMWOOD AVE STE 222
ROCHESTER NY
14620-3426
US

V. Phone/Fax

Practice location:
  • Phone: 585-542-9272
  • Fax: 585-360-2026
Mailing address:
  • Phone: 585-542-9272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. YULIYA SNYDER
Title or Position: OWNER/ PHYSICIAN
Credential: MD
Phone: 585-542-9272