Healthcare Provider Details
I. General information
NPI: 1528058104
Provider Name (Legal Business Name): SARAH MAUREEN SNYDER P.A.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/25/2005
Last Update Date: 10/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6480 HARRISON AVENUE SUITE 201
CINCINNATI OH
45241-6378
US
IV. Provider business mailing address
6480 HARRISON AVENUE SUITE 100
CINCINNATI OH
45241-6378
US
V. Phone/Fax
- Phone: 513-354-3700
- Fax: 513-354-7651
- Phone: 513-354-3700
- Fax: 513-354-7601
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AS0400X |
| Taxonomy | Surgical Physician Assistant |
| License Number | 50-00-2027 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: