Basic Information
| Provider Information | |||||||||
| NPI: | 1184807067 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SNEEDEN | ||||||||
| FirstName: | CYNTHIA | ||||||||
| MiddleName: | W. | ||||||||
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| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 263 MAIN ST | ||||||||
| Address2: | BOX 128 | ||||||||
| City: | WHITEHOUSE STATION | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088893620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9085342249 | ||||||||
| FaxNumber: | 9085346634 | ||||||||
| Practice Location | |||||||||
| Address1: | 263 MAIN ST | ||||||||
| Address2: | BOX 128 | ||||||||
| City: | WHITEHOUSE STATION | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088893620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9085342249 | ||||||||
| FaxNumber: | 9085346634 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2007 | ||||||||
| LastUpdateDate: | 12/13/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 25MP00047200 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.