Healthcare Provider Details

I. General information

NPI: 1154391134
Provider Name (Legal Business Name): BARRY JAY SNYDER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 WOODBOURNE RD SUITE 301
LEVITTOWN PA
19057-1500
US

IV. Provider business mailing address

1609 WOODBOURNE RD STE 301
LEVITTOWN PA
19057-1500
US

V. Phone/Fax

Practice location:
  • Phone: 215-547-1100
  • Fax:
Mailing address:
  • Phone: 215-547-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD017167E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: