Provider Demographics
NPI:1679547871
Name:SNYDER, STEPHEN E (PA)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:E
Last Name:SNYDER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:14048-2226
Mailing Address - Country:US
Mailing Address - Phone:716-206-6474
Mailing Address - Fax:716-363-1235
Practice Address - Street 1:325 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-2114
Practice Address - Country:US
Practice Address - Phone:716-366-2122
Practice Address - Fax:716-363-1235
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006791363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant