MEDICARE: ALLISON E. SNYDER D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OS013497	PA

General Provider Information

NPI Number	:	1740230598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON E. SNYDER D.O.

Provider Business Mailing Address
First Line	:	2501 W 12TH ST
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16505-4527
Country	:	US
Telephone Number	:	814-461-6626
Fax Number	:	814-871-6351

Provider Business Practice Location Address
First Line	:	2501 W 12TH ST
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16505-4527
Country	:	US
Telephone Number	:	814-461-6626
Fax Number	:	814-871-6351

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	10/07/2020

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