Provider Demographics
NPI:1710087788
Name:SNOW WILLIAMS, DENISE K (OD)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:K
Last Name:SNOW WILLIAMS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368
Mailing Address - Country:US
Mailing Address - Phone:781-963-8448
Mailing Address - Fax:781-963-5289
Practice Address - Street 1:9 WARREN STREET
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368
Practice Address - Country:US
Practice Address - Phone:781-963-8448
Practice Address - Fax:781-963-5289
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3651152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
468944OtherTUFTS HEALTH PLAN
0002693OtherNEIGHBORHOOD HEALTH PLAN
19316OtherSPECTERA
331044505OtherCIGNA HEALTHCARE
W16275OtherBLUE CROSS BLUE SHIELD
MA0338150Medicaid
152632OtherHARVARD PILGRIM HEALTH PL
331044505OtherUNITED HEALTH CARE
468944OtherTUFTS HEALTH PLAN