Healthcare Provider Details

I. General information

NPI: 1063792125
Provider Name (Legal Business Name): NIMROD SNIR M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2011
Last Update Date: 08/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 1ST AVE. NYU LANGONE MEDICAL CENTER
NEW YORK NY
10016-7804
US

IV. Provider business mailing address

425 E 63RD ST W10H
NEW YORK NY
10065-7804
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-5506
  • Fax:
Mailing address:
  • Phone: 917-628-7033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number60 P81264
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: