Provider Demographics
NPI:1609848480
Name:SNOWBALL, HALINA M (MD)
Entity Type:Individual
Prefix:
First Name:HALINA
Middle Name:M
Last Name:SNOWBALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2015 WEST MAIN STREET
Mailing Address - Street 2:SUITE 350
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902
Mailing Address - Country:US
Mailing Address - Phone:203-863-4588
Mailing Address - Fax:203-863-4586
Practice Address - Street 1:2015 WEST MAIN STREET
Practice Address - Street 2:SUITE 350
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902
Practice Address - Country:US
Practice Address - Phone:203-863-4588
Practice Address - Fax:203-863-4586
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2016-02-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT037841208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT250011519OtherRAILROAD MEDICARE
CT250011519OtherRAILROAD MEDICARE
CTE72098Medicare UPIN