Healthcare Provider Details

I. General information

NPI: 1164922571
Provider Name (Legal Business Name): AMY MARIE SNYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2018
Last Update Date: 02/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3365 HIGH POINT BLVD
BETHLEHEM PA
18017-7806
US

IV. Provider business mailing address

1019 HOWERTOWN RD
CATASAUQUA PA
18032-1611
US

V. Phone/Fax

Practice location:
  • Phone: 610-954-5433
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN600341
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: