Healthcare Provider Details

I. General information

NPI: 1346618246
Provider Name (Legal Business Name): SNYDER MEDICAL SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2015
Last Update Date: 11/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1540 MAPLE RD
WILLIAMSVILLE NY
14221-3647
US

IV. Provider business mailing address

275 NORTHPOINTE PKWY SUITE 50
AMHERST NY
14228-1895
US

V. Phone/Fax

Practice location:
  • Phone: 716-568-3600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number270066
License Number StateNY

VIII. Authorized Official

Name: MATTHEW RUSK
Title or Position: OWNER
Credential: DO
Phone: 716-445-3002