Provider Demographics
NPI:1932706660
Name:SNYDER, GREGORY DANIEL (CRNP, NP-C)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:DANIEL
Last Name:SNYDER
Suffix:
Gender:M
Credentials:CRNP, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18512-2349
Mailing Address - Country:US
Mailing Address - Phone:570-709-7878
Mailing Address - Fax:
Practice Address - Street 1:4 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NANTICOKE
Practice Address - State:PA
Practice Address - Zip Code:18634-1602
Practice Address - Country:US
Practice Address - Phone:570-258-3939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022621363LP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care