Healthcare Provider Details

I. General information

NPI: 1124039227
Provider Name (Legal Business Name): JONATHAN A SCHNEIDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1423 CHAPEL ST ANESTHESIA ASSOCIATES OF NEW HAVEN
NEW HAVEN CT
06511
US

IV. Provider business mailing address

1423 CHAPEL ST ANESTHESIA ASSOCIATES OF NEW HAVEN
NEW HAVEN CT
06511
US

V. Phone/Fax

Practice location:
  • Phone: 203-789-3538
  • Fax: 203-867-5461
Mailing address:
  • Phone: 203-789-3538
  • Fax: 203-867-5461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number021189
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: