Provider Demographics
NPI:1558793711
Name:SNYDER, JULIA L (TEACHER)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:L
Last Name:SNYDER
Suffix:
Gender:F
Credentials:TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8156 242ND ST
Mailing Address - Street 2:
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426-1314
Mailing Address - Country:US
Mailing Address - Phone:315-576-6179
Mailing Address - Fax:
Practice Address - Street 1:8156 242ND ST
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426-1314
Practice Address - Country:US
Practice Address - Phone:315-576-6179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY931921390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program