Provider Demographics
NPI:1558133173
Name:SNIDER, JEANNE (RBT)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:SNIDER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1485 FRONT ST APT 52
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-2252
Mailing Address - Country:US
Mailing Address - Phone:516-495-2237
Mailing Address - Fax:
Practice Address - Street 1:445 BROADHOLLOW RD STE 25
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-3645
Practice Address - Country:US
Practice Address - Phone:516-280-1327
Practice Address - Fax:516-453-1339
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRBT-23-265426374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician