Provider Demographics
NPI:1891169488
Name:GIRI, SNEHA GOSWAMI (MD)
Entity type:Individual
Prefix:DR
First Name:SNEHA
Middle Name:GOSWAMI
Last Name:GIRI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-996-3880
Mailing Address - Fax:314-996-8610
Practice Address - Street 1:1044 N MASON RD
Practice Address - Street 2:DEPT OTOLARYNGOLOGY, STE L10
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-6431
Practice Address - Country:US
Practice Address - Phone:314-996-3880
Practice Address - Fax:314-996-8610
Is Sole Proprietor?:No
Enumeration Date:2015-11-19
Last Update Date:2025-04-17
Deactivation Date:2019-03-19
Deactivation Code:
Reactivation Date:2019-03-27
Provider Licenses
StateLicense IDTaxonomies
MO2024007270207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200140610Medicaid