Provider Demographics
NPI:1093922874
Name:RONDA G. SNOWDEN, MD, PLLC
Entity Type:Organization
Organization Name:RONDA G. SNOWDEN, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SNOWDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-354-2424
Mailing Address - Street 1:2001 MARCUS AVE
Mailing Address - Street 2:SUITE N210
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1011
Mailing Address - Country:US
Mailing Address - Phone:516-354-2424
Mailing Address - Fax:516-354-0843
Practice Address - Street 1:2001 MARCUS AVE
Practice Address - Street 2:SUITE N210
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1011
Practice Address - Country:US
Practice Address - Phone:516-354-2424
Practice Address - Fax:516-354-0843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY165199207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY865D51OtherEMPIRE BLUE CROSS BLUE SHIELD
NYA64512Medicare UPIN