=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508028010
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JAMES E SNYDER, M.D.,P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/26/2008
-----------------------------------------------------
Last Update Date | 12/02/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6 BUTTRICK RD SUITE 301
-----------------------------------------------------
City | LONDONDERRY
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03053-3417
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-425-6530
-----------------------------------------------------
Fax | 603-434-9229
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6 BUTTRICK RD SUITE 301
-----------------------------------------------------
City | LONDONDERRY
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03053-3417
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-425-6530
-----------------------------------------------------
Fax | 603-434-9229
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MS. KIMBERLEE M PRENDERGAST
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 603-425-6530
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number | A363
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Y00000X
-----------------------------------------------------
Taxonomy Name | Otolaryngology Physician
-----------------------------------------------------
License Number | 8724
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------