Provider Demographics
NPI:1275136236
Name:SNOW, EVAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:
Last Name:SNOW
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 SCHOOLHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-5955
Mailing Address - Country:US
Mailing Address - Phone:518-937-1338
Mailing Address - Fax:
Practice Address - Street 1:160 FAIRVIEW AVE STE 20
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-8405
Practice Address - Country:US
Practice Address - Phone:518-828-0050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY065491183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty