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General NPI Number Information
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NPI Number | 1568761948
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Entity Type | Individual
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Provider Name | RANDALL G SNYDER
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Gender | Male
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Dates
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Enumeration Date | 03/24/2011
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Last Update Date | 03/24/2011
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Provider Practice Location Address
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Address Line | 499 CANAL ST
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City | BRATTLEBORO
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State | VT
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Zip | 05301-7112
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Country | US
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Telephone | 802-257-4204
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Fax |
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Provider Business Mailing Address
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Address Line | 2535 PETERS LN
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City | NISKAYUNA
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State | NY
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Zip | 12309-2412
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Country | US
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Telephone | 518-339-1583
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 033.0055157
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License Number State | VT
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