Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 0143491 | NY |
NPI | 1003187121 |
---|---|
Provider Name | Mrs. Judy Ann Snyder |
First Address | Massapequa Park, NY 11762-1435 |
Second Address | Massapequa Park, NY 11762-1435 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2012 |
Last Update Date | 20/01/2012 |