Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207NS0135X | Procedural Dermatology | 013737-1 | NY |
NPI | 1407185440 |
---|---|
Provider Name | Miss Aja Marie Snow |
First Address | Carmel, NY 10512-4947 |
Second Address | Mount Kisco, NY 10549-3412 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2009 |
Last Update Date | 17/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H96082 | (02) | NY |