Healthcare Provider Details

I. General information

NPI: 1457905903
Provider Name (Legal Business Name): HEATHER SNYDER OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2019
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 BROOKTREE RD STE 2800
WEXFORD PA
15090-6706
US

IV. Provider business mailing address

6600 BROOKTREE RD STE 2800
WEXFORD PA
15090-6706
US

V. Phone/Fax

Practice location:
  • Phone: 724-719-2712
  • Fax: 855-958-5414
Mailing address:
  • Phone: 724-719-2712
  • Fax: 855-958-5414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number2805
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number2805
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2805
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: