Healthcare Provider Details

I. General information

NPI: 1457744773
Provider Name (Legal Business Name): KRISTINA SNYDER R.D., LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2015
Last Update Date: 05/22/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 FRIENDS LN STE 106
NEWTOWN PA
18940-1885
US

IV. Provider business mailing address

712 N TYSON AVE
GLENSIDE PA
19038-3830
US

V. Phone/Fax

Practice location:
  • Phone: 267-217-1330
  • Fax: 215-857-0016
Mailing address:
  • Phone: 215-687-0991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN005611
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: