Healthcare Provider Details

I. General information

NPI: 1275758682
Provider Name (Legal Business Name): NANCY LYNN SNYDERMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PHILADELPHIA VA MEDICAL CENTER UNIVERSITY & WOODLAND AVENUES
PHILADELPHIA PA
19104
US

IV. Provider business mailing address

37 PHEASANT HILL RD
PRINCETON NJ
08540-7509
US

V. Phone/Fax

Practice location:
  • Phone: 215-823-5800
  • Fax:
Mailing address:
  • Phone: 609-688-8379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD021266E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: