Provider Demographics
NPI:1760441190
Name:SNYDER, LEE ALISON
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:ALISON
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 1:33 IRONWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-1760
Mailing Address - Country:US
Mailing Address - Phone:410-581-1500
Mailing Address - Fax:410-581-0577
Practice Address - Street 1:23 CROSSROADS DR
Practice Address - Street 2:SUITE #310
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5420
Practice Address - Country:US
Practice Address - Phone:410-581-1500
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0060543207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH96033Medicare UPIN