Provider Demographics
NPI:1609087170
Name:GASSNER-SNYDER, JUTTA E
Entity Type:Individual
Prefix:MRS
First Name:JUTTA
Middle Name:E
Last Name:GASSNER-SNYDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BUCKINGHAM GARDEN PKWY
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-1214
Mailing Address - Country:US
Mailing Address - Phone:973-671-8863
Mailing Address - Fax:
Practice Address - Street 1:9 BUCKINGHAM GARDEN PKWY
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-1214
Practice Address - Country:US
Practice Address - Phone:973-671-8863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00052500171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist