Provider Demographics
NPI:1326376153
Name:SNOW, DOV A (PHD)
Entity Type:Individual
Prefix:
First Name:DOV
Middle Name:A
Last Name:SNOW
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 OAKFORD ST
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-3218
Mailing Address - Country:US
Mailing Address - Phone:516-507-0134
Mailing Address - Fax:347-695-9701
Practice Address - Street 1:283 OAKFORD ST
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-3218
Practice Address - Country:US
Practice Address - Phone:516-507-0134
Practice Address - Fax:347-695-9701
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-07
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X, 103TH0004X
NY025164103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103T00000XBehavioral Health & Social Service ProvidersPsychologist