Provider Demographics
NPI:1376535591
Name:SNYDER, HUGH DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:HUGH
Middle Name:DAVID
Last Name:SNYDER
Suffix:
Gender:M
Credentials:MD
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 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 OVERLOOK RD
Practice Address - Street 2:SUITE 140
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-3577
Practice Address - Country:US
Practice Address - Phone:908-277-0050
Practice Address - Fax:908-277-0201
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA069976207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8527700Medicaid
NJ049657Medicare ID - Type Unspecified
NJ8527700Medicaid