Provider Demographics
NPI:1629404116
Name:SNYDER, ERICA
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name: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 RAILROAD AVE
Mailing Address - Street 2:P.O. BOX 462
Mailing Address - City:SILVER SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:14550-9814
Mailing Address - Country:US
Mailing Address - Phone:585-322-6758
Mailing Address - Fax:
Practice Address - Street 1:9 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:14550-9814
Practice Address - Country:US
Practice Address - Phone:585-322-6758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305304164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse