Provider Demographics
NPI:1154582583
Name:SNYDER, CARLYN W (MD)
Entity type:Individual
Prefix:DR
First Name:CARLYN
Middle Name:W
Last Name:SNYDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CARLY
Other - Middle Name:
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:201 E 87TH ST
Mailing Address - Street 2:#16J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3203
Mailing Address - Country:US
Mailing Address - Phone:212-348-0175
Mailing Address - Fax:212-426-0784
Practice Address - Street 1:201 E 87TH ST
Practice Address - Street 2:16J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3203
Practice Address - Country:US
Practice Address - Phone:212-348-0175
Practice Address - Fax:212-426-0784
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2542192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry