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Nicole Lynn Snide

Specialist in Malone, NY. Individual provider (NPI-1).

NPI number1295097673
StatusActive
Last updated in NPPESJun 12, 2012

Details

NPI
1295097673
Entity type
Individual (NPI-1)
Name
Nicole Lynn Snide
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 12, 2012
Last updated
Jun 12, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
174400000X Specialist198093081NYYes

Practice location

23 Huskie Lane
Feh Boces
Malone, NY 12953

Phone 518-483-5230

Mailing address

23 Huskie Lane
Feh Boces
Malone, NY 12953

Phone 518-483-5230

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