Healthcare Provider Details

I. General information

NPI: 1235877820
Provider Name (Legal Business Name): MIRIAM ANN SNOW MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MIRIAM ANN HOLZMAN MD

II. Dates (important events)

Enumeration Date: 05/24/2022
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 W 168TH ST
NEW YORK NY
10032-3720
US

IV. Provider business mailing address

222 MONTGOMERY ST APT 3J
JERSEY CITY NJ
07302-5014
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-5697
  • Fax:
Mailing address:
  • Phone: 734-277-1946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number1235877820
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: