Basic Information
| Provider Information | |||||||||
| NPI: | 1033158175 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SNYDER | ||||||||
| FirstName: | JILL | ||||||||
| MiddleName: | T. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 E BROAD ST | ||||||||
| Address2: | |||||||||
| City: | HAZLETON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 182016835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705016368 | ||||||||
| FaxNumber: | 5705014754 | ||||||||
| Practice Location | |||||||||
| Address1: | 642 STATE ROUTE 93 HWY | ||||||||
| Address2: | |||||||||
| City: | SUGARLOAF | ||||||||
| State: | PA | ||||||||
| PostalCode: | 182493127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5707081505 | ||||||||
| FaxNumber: | 5707081506 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2006 | ||||||||
| LastUpdateDate: | 04/28/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | OS009234L | PA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.