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General NPI Number Information
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NPI Number | 1265423743
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Entity Type | Individual
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Provider Name | LISA SIMONETTA SNYDER RN,MSN,FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 03/11/2021
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Provider Practice Location Address
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Address Line | 134 HOMER AVE
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City | CORTLAND
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State | NY
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Zip | 13045-1206
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Country | US
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Telephone | 607-756-3561
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Fax | 607-428-5142
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Provider Business Mailing Address
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Address Line | 134 HOMER AVE PO BOX 628
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City | CORTLAND
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State | NY
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Zip | 13045-1206
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Country | US
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Telephone | 607-756-3561
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Fax | 607-428-5142
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | F3322590
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License Number State | NY
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