Provider Demographics
NPI:1992069694
Name:SNYDER, OFIRA (MS)
Entity type:Individual
Prefix:
First Name:OFIRA
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:949 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-3545
Mailing Address - Country:US
Mailing Address - Phone:718-253-4213
Mailing Address - Fax:
Practice Address - Street 1:949 E 10TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-3545
Practice Address - Country:US
Practice Address - Phone:718-253-4213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist