Provider Demographics
NPI:1316501711
Name:SNYDER, ROSE
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:
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 1:60 COMMERCIAL ST.
Mailing Address - Street 2:SUITE 404
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5096
Mailing Address - Country:US
Mailing Address - Phone:603-228-1763
Mailing Address - Fax:603-228-7088
Practice Address - Street 1:60 COMMERCIAL ST.
Practice Address - Street 2:SUITE 404
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5096
Practice Address - Country:US
Practice Address - Phone:603-228-1763
Practice Address - Fax:603-228-7088
Is Sole Proprietor?:No
Enumeration Date:2019-05-01
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NH363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program