Provider Demographics
NPI:1003949991
Name:RICHARD R SNIDER PSYD & ASSOCIATES PA
Entity Type:Organization
Organization Name:RICHARD R SNIDER PSYD & ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:SNIDER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD & ASSOCIATES PA
Authorized Official - Phone:954-522-4941
Mailing Address - Street 1:1700 SW 22ND ST
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316
Mailing Address - Country:US
Mailing Address - Phone:954-522-4941
Mailing Address - Fax:954-522-4357
Practice Address - Street 1:2101 S ANDREWS AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316
Practice Address - Country:US
Practice Address - Phone:954-522-4941
Practice Address - Fax:954-522-4357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4173103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1407961378OtherRICHARD SNIDER NPI
73493AMedicare ID - Type Unspecified