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General NPI Number Information
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NPI Number | 1588980452
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Entity Type | Individual
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Provider Name | MR. JORDON VICTOR SNOWDON
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Gender | Male
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Dates
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Enumeration Date | 04/15/2010
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Last Update Date | 04/15/2010
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Provider Practice Location Address
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Address Line | 1940 COMMERCE ST SUITE 210
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City | YORKTOWN HEIGHTS
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State | NY
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Zip | 10598-4428
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Country | US
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Telephone | 914-631-9020
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Fax |
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Provider Business Mailing Address
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Address Line | 51 LAKEWOOD AVE
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City | MONTICELLO
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State | NY
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Zip | 12701-2027
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Country | US
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Telephone | 845-798-3537
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 007369-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA21430
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License Number State | FL
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