Provider Demographics
NPI:1861405011
Name:SNYDER, DEBORAH W (PT)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:W
Last Name:SNYDER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1068 W. BALTIMORE PIKE
Mailing Address - Street 2:LOBBY LEVEL
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063
Mailing Address - Country:US
Mailing Address - Phone:610-891-3030
Mailing Address - Fax:610-891-3035
Practice Address - Street 1:1068 W BALTIMORE PIKE
Practice Address - Street 2:LOBBY LEVEL
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5104
Practice Address - Country:US
Practice Address - Phone:610-891-3030
Practice Address - Fax:610-891-3035
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT001646E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0097690000OtherIBC/KEY
PASN402968OtherPABS
PA028410J03Medicare ID - Type Unspecified