Healthcare Provider Details
I. General information
NPI: 1871589259
Provider Name (Legal Business Name): CHRISTOPHER ALFRED SNYDER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/21/2005
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1016 W FRONT ST
BERWICK PA
18603-4525
US
IV. Provider business mailing address
1016 W FRONT ST
BERWICK PA
18603-4525
US
V. Phone/Fax
- Phone: 570-802-0102
- Fax: 570-802-0104
- Phone: 570-802-0102
- Fax: 570-802-0104
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | OS009236L |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207N00000X |
| Taxonomy | Dermatology Physician |
| License Number | OS009236L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: