Healthcare Provider Details

I. General information

NPI: 1316128127
Provider Name (Legal Business Name): SNYDER OBGYN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2007
Last Update Date: 11/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3980 SHERIDAN DR SUITE 400
AMHERST NY
14226-1727
US

IV. Provider business mailing address

3980 SHERIDAN DR SUITE 400
AMHERST NY
14226-1727
US

V. Phone/Fax

Practice location:
  • Phone: 716-929-2600
  • Fax: 716-929-2493
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberE84823
License Number StateNY

VIII. Authorized Official

Name: STEPHEN A MECHTLER
Title or Position: PHYSICISN
Credential: M.D.
Phone: 716-929-2600