Healthcare Provider Details

I. General information

NPI: 1033513411
Provider Name (Legal Business Name): TERESA M. SNYDER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2014
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 COLVIN BLVD
TONAWANDA NY
14223-1440
US

IV. Provider business mailing address

6091 MEADOW LAKES DR
EAST AMHERST NY
14051-2005
US

V. Phone/Fax

Practice location:
  • Phone: 716-874-4060
  • Fax:
Mailing address:
  • Phone: 716-741-3280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number306892
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: