MEDICARE: ACADEMY OF PODIATRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1740713817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACADEMY OF PODIATRY

Provider Business Mailing Address
First Line	:	5841 LIBRARY RD
Second Line	:
City	:	BETHEL PARK
State	:	PA
Zip	:	15102-3333
Country	:	US
Telephone Number	:	412-831-1515
Fax Number	:	412-831-2115

Provider Business Practice Location Address
First Line	:	1976 LINCOLN WAY
Second Line	:
City	:	WHITE OAK
State	:	PA
Zip	:	15131-2416
Country	:	US
Telephone Number	:	412-831-1515
Fax Number	:	412-831-2115

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	JOHN M SNYDER
Credential	:	DPM
Telephone Number	:	412-831-1515

Provider Enumeration Date	:	04/06/2017
Last Update Date	:	04/06/2017

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