Healthcare Provider Details

I. General information

NPI: 1417273228
Provider Name (Legal Business Name): MARK SNYDER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2010
Last Update Date: 11/03/2021
Certification Date: 11/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 5TH AVE 4TH FLOOR FALK COMPREHENSIVE LUNG CENTER
PITTSBURGH PA
15213-3403
US

IV. Provider business mailing address

3549 5TH AVE MONTEFIORE 6NW PACCM
PITTSBURGH PA
15213-3301
US

V. Phone/Fax

Practice location:
  • Phone: 412-648-6161
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number267715
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: