Provider Demographics
NPI:1477532752
Name:SNOW, IRENE S (MD)
Entity Type:Individual
Prefix:DR
First Name:IRENE
Middle Name:S
Last Name:SNOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6255 SHERIDAN DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4836
Mailing Address - Country:US
Mailing Address - Phone:715-857-8666
Mailing Address - Fax:716-857-8944
Practice Address - Street 1:325 ESSJAY RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-8216
Practice Address - Country:US
Practice Address - Phone:716-630-1167
Practice Address - Fax:716-250-5960
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2012-06-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY147510-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0402267OtherIHA
NY161000580OtherEMPIRE PLAN
NY161000580OtherGHI
NY161000580OtherNORTH AMERICAN PREFERRED
NY147510-2WOtherWORKER'S COMPENSATION
NY110114164OtherRR MEDICARE
NY00010169401OtherUNIVERA
NY000500080005OtherHEALTH NOW
NY00010169401OtherUNIVERA
NY0402267OtherIHA