Individual
DR. G GORDON SNYDER III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 COTTAGE GROVE RD, A-230, BLOOMFIELD, CT 06002-3080
(860) 242-5274
(860) 242-3643
Mailing address
701 COTTAGE GROVE RD, A-230, BLOOMFIELD, CT 06002-3080
(860) 242-5274
(860) 242-3643
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
15262
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001152628
—
CT
01
—
040000101
MEDICARE PTAN
—
Enumeration date
09/26/2006
Last updated
06/21/2010
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