Healthcare Provider Details

I. General information

NPI: 1154692614
Provider Name (Legal Business Name): JULIA SARA SCHNEIDER N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2012
Last Update Date: 01/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 BEAUVOIR AVE OVERLOOK HOSPITAL, MAC II, SUITE 200
SUMMIT NJ
07901-3533
US

IV. Provider business mailing address

99 BEAUVOIR AVE OVERLOOK HOSPITAL, MAC II, SUITE 200
SUMMIT NJ
07901-3533
US

V. Phone/Fax

Practice location:
  • Phone: 908-522-5757
  • Fax:
Mailing address:
  • Phone: 908-522-5757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number26NJ00359000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: