Provider Demographics
NPI:1033467865
Name:SNYDER, NATHANIEL D (PA-C)
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:D
Last Name:SNYDER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13579
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19612-3579
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:301 SOUTH 7TH AVE
Practice Address - Street 2:SUITE 1120
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1493
Practice Address - Country:US
Practice Address - Phone:610-741-0580
Practice Address - Fax:610-374-1902
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055678363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant