1588645972 NPI number — MRS. BETH LYNNE SNYDER P.T.

Table of content: MRS. BETH LYNNE SNYDER P.T. (NPI 1588645972)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588645972 NPI number — MRS. BETH LYNNE SNYDER P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SNYDER
Provider First Name:
BETH
Provider Middle Name:
LYNNE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
P.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FOX
Provider Other First Name:
BETH
Provider Other Middle Name:
LYNNE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
P.T.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1588645972
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/27/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
68 RED HAWK HOLLOW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAPPINGERS FALLS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12590-6240
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-462-7672
Provider Business Mailing Address Fax Number:
845-297-8596

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 DELAVERGNE AVE
Provider Second Line Business Practice Location Address:
C/O CENTER FOR PHYSICAL THERAPY
Provider Business Practice Location Address City Name:
WAPPINGERS FALLS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12590-1202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-297-4789
Provider Business Practice Location Address Fax Number:
845-297-8596
Provider Enumeration Date:
11/11/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  009853 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 83397 . This is a "OPERATING ENGRS LCL 825" identifier . This identifiers is of the category "OTHER".
  • Identifier: 437214 . This is a "MVP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7359471 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1359230 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 819559 . This is a "MANAGED PHYSICAL NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3096308 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5162115 . This is a "CCN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 650015382 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: DUS060 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".




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