Provider Demographics
NPI:1033212485
Name:SNYDER, CANDRA LYNN (ANP)
Entity Type:Individual
Prefix:MS
First Name:CANDRA
Middle Name:LYNN
Last Name:SNYDER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:MS
Other - First Name:CANDRA
Other - Middle Name:LYNN
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ANP
Mailing Address - Street 1:77 NORTH CENTRE AVENUE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570
Mailing Address - Country:US
Mailing Address - Phone:516-764-7246
Mailing Address - Fax:516-678-3525
Practice Address - Street 1:77 NORTH CENTRE AVENUE
Practice Address - Street 2:SUITE 202
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570
Practice Address - Country:US
Practice Address - Phone:516-764-7246
Practice Address - Fax:516-678-3525
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF303410363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP3398896OtherOXFORD
NY2371154OtherUNITED HEALTHCARE
NY4C9355OtherPHS HEALTHNET
NY4C9355OtherPHS HEALTHNET
Q10529Medicare UPIN