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General NPI Number Information
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NPI Number | 1215009691
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Entity Type | Organization
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Legal Business Name | BRUCE SNIDER MD PSC
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 510 GRAVES AVE STE 210
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City | ERLANGER
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State | KY
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Zip | 41018-3309
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Country | US
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Telephone | 859-341-5014
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Fax | 859-341-5136
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Provider Business Mailing Address
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Address Line | 510 GRAVES AVE STE 210
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City | ERLANGER
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State | KY
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Zip | 41018-3309
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Country | US
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Telephone | 859-341-5014
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Fax | 859-341-5136
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | MR. BRUCE A SNIDER
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Credential | MD
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Telephone | 859-341-5014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 16835
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License Number State | KY
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