Provider Demographics
NPI:1154391134
Name:SNYDER, BARRY JAY (MD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:JAY
Last Name:SNYDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1609 WOODBOURNE RD
Mailing Address - Street 2:STE 301
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19057-1500
Mailing Address - Country:US
Mailing Address - Phone:215-547-1100
Mailing Address - Fax:
Practice Address - Street 1:1609 WOODBOURNE RD
Practice Address - Street 2:SUITE 301
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19057-1500
Practice Address - Country:US
Practice Address - Phone:215-547-1100
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD017167E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA030221OtherBLUE SHIELD OF PA
PA5955OtherAETNA
PA0021797000OtherPERSONAL CHOICE
PA0006445810002Medicaid
PA0021797000OtherAMERIHEALTH
PA0006445810002Medicaid
PA0021797000OtherAMERIHEALTH