Provider Demographics
NPI:1790947695
Name:SNYDER, BERNADETTE JEAN (RN)
Entity Type:Individual
Prefix:MS
First Name:BERNADETTE
Middle Name:JEAN
Last Name:SNYDER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 N EDWARDS AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13206-2208
Mailing Address - Country:US
Mailing Address - Phone:315-432-4414
Mailing Address - Fax:
Practice Address - Street 1:309 N EDWARDS AVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13206-2208
Practice Address - Country:US
Practice Address - Phone:315-432-4414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY598387163W00000X
NY271399-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse