Healthcare Provider Details

I. General information

NPI: 1124091269
Provider Name (Legal Business Name): MICHAEL SNYDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 04/18/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 MARKET ST
YONKERS NY
10710-7616
US

IV. Provider business mailing address

800 WESTCHESTER AVE STE N715
RYE BROOK NY
10573-1369
US

V. Phone/Fax

Practice location:
  • Phone: 914-305-2725
  • Fax: 914-607-6241
Mailing address:
  • Phone: 914-607-5730
  • Fax: 914-457-1195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number029942
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number143309
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: