Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | DC006272L | PA |
NPI | 1699718817 |
---|---|
Provider Name | John Snyder |
First Address | Telford, PA 18969-2451 |
Second Address | Sumneytown, PA 18969 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 08/07/2007 |