Provider Demographics
NPI:1245126903
Name:SNOW, RAYLYNN LOUISE (LPN, PTA)
Entity type:Individual
Prefix:
First Name:RAYLYNN
Middle Name:LOUISE
Last Name:SNOW
Suffix:
Gender:F
Credentials:LPN, PTA
Other - Prefix:
Other - First Name:RAYLYNN
Other - Middle Name:LOUISE
Other - Last Name:CARLSSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:51 S WOODHILL AVE
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13904-2728
Mailing Address - Country:US
Mailing Address - Phone:607-651-7768
Mailing Address - Fax:
Practice Address - Street 1:101 LEWIS RD
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-1049
Practice Address - Country:US
Practice Address - Phone:607-651-7768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344885-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse