Provider Demographics
NPI:1871884890
Name:SNAVELY, RENEE NICHOLE
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:NICHOLE
Last Name:SNAVELY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:NICHOLE
Other - Last Name:BRANDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3903A SPAATZ DR
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08641-1629
Mailing Address - Country:US
Mailing Address - Phone:210-279-2820
Mailing Address - Fax:
Practice Address - Street 1:3903A SPAATZ DR
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08641-1629
Practice Address - Country:US
Practice Address - Phone:210-279-2820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians