Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 25MA07658400 | NJ |
N | 207PP0204X | Pediatric Emergency Physician | 25MA07658400 | NJ |
NPI | 1184654766 |
---|---|
Provider Name | Dr. Laura Snyder |
First Address | Long Branch, NJ 07740-6303 |
Second Address | Long Branch, NJ 07740-6303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 14/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H23364 | (02) | NJ |