Provider Demographics
NPI:1235779158
Name:SNOWDEN, SHAMIYA
Entity Type:Individual
Prefix:
First Name:SHAMIYA
Middle Name:
Last Name:SNOWDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19443
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14619-0443
Mailing Address - Country:US
Mailing Address - Phone:585-309-2561
Mailing Address - Fax:
Practice Address - Street 1:240 AUGUSTINE ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14613-1452
Practice Address - Country:US
Practice Address - Phone:585-309-2561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-08
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY778107163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse