Provider Demographics
NPI:1457905903
Name:SNYDER, HEATHER (OD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 BROOKTREE RD STE 2800
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-6706
Mailing Address - Country:US
Mailing Address - Phone:724-719-2712
Mailing Address - Fax:855-958-5414
Practice Address - Street 1:6600 BROOKTREE RD STE 2800
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-6706
Practice Address - Country:US
Practice Address - Phone:724-719-2712
Practice Address - Fax:855-958-5414
Is Sole Proprietor?:No
Enumeration Date:2019-08-01
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2805152WP0200X, 152WV0400X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2D3576OtherMEDICARE PTAN