MEDICARE: KATHLEEN A SNYDER A.N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	F307310-1	NY

General Provider Information

NPI Number	:	1770966657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN A SNYDER A.N.P.

Provider Business Mailing Address
First Line	:	PO BOX 230
Second Line	:
City	:	WARSAW
State	:	NY
Zip	:	14569-0230
Country	:	US
Telephone Number	:	585-786-2290
Fax Number	:	585-786-2853

Provider Business Practice Location Address
First Line	:	2261 STATE ROUTE 19 N
Second Line	:
City	:	WARSAW
State	:	NY
Zip	:	14569-9334
Country	:	US
Telephone Number	:	585-786-2290
Fax Number	:	585-786-2853

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2015
Last Update Date	:	07/09/2015

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