Provider Demographics
NPI:1144269135
Name:DANA-SNYDER, PAMELA D (MD)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:D
Last Name:DANA-SNYDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 WOLF HILL RD
Mailing Address - Street 2:
Mailing Address - City:EAST SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02537-1512
Mailing Address - Country:US
Mailing Address - Phone:781-526-7846
Mailing Address - Fax:
Practice Address - Street 1:830 CHALKSTONE AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-4734
Practice Address - Country:US
Practice Address - Phone:401-273-7000
Practice Address - Fax:401-457-1460
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA55506207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ06149OtherINDIVIDUAL MEDICARE NUMBER
MA3022161Medicaid
MAJ06149OtherINDIVIDUAL MEDICARE NUMBER