Healthcare Provider Details

I. General information

NPI: 1255343919
Provider Name (Legal Business Name): CRAIG WARREN SNYDER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

315 S CROUSE AVE SUITE 302
SYRACUSE NY
13210-1845
US

IV. Provider business mailing address

4204 GORDON COOPER DR
JAMESVILLE NY
13078-9781
US

V. Phone/Fax

Practice location:
  • Phone: 315-491-0253
  • Fax: 315-478-1878
Mailing address:
  • Phone: 315-491-0253
  • Fax: 315-472-1759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number000020
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: