MEDICARE: DR. STEVEN I SNYDER DDS

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	036047	NY

General Provider Information

NPI Number	:	1801870282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN I SNYDER DDS

Provider Business Mailing Address
First Line	:	41 ELDERWOOD DR
Second Line	:
City	:	ST JAMES
State	:	NY
Zip	:	11780-3438
Country	:	US
Telephone Number	:	631-584-3210
Fax Number	:

Provider Business Practice Location Address
First Line	:	264 UNION AVE
Second Line	:
City	:	HOLBROOK
State	:	NY
Zip	:	11741-1824
Country	:	US
Telephone Number	:	631-588-1200
Fax Number	:	631-588-1779

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

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	07/08/2007

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