Healthcare Provider Details

I. General information

NPI: 1821781485
Provider Name (Legal Business Name): SARAH JANE SNYDER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2023
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 RIVER RD
CLEARFIELD PA
16830-6026
US

IV. Provider business mailing address

305 GREEN RIDGE DR
DU BOIS PA
15801-2337
US

V. Phone/Fax

Practice location:
  • Phone: 814-205-1250
  • Fax:
Mailing address:
  • Phone: 814-591-1735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA064781
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberOA006530
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: