Healthcare Provider Details

I. General information

NPI: 1356511968
Provider Name (Legal Business Name): MS. LORI ANN SCHNEIDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LORI SCHNEIDER RN

II. Dates (important events)

Enumeration Date: 03/11/2008
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1042 COUNTY ROUTE 17
BERNHARDS BAY NY
13028-4123
US

IV. Provider business mailing address

1042 COUNTY ROUTE 17
BERNHARDS BAY NY
13028-4123
US

V. Phone/Fax

Practice location:
  • Phone: 315-675-8319
  • Fax:
Mailing address:
  • Phone: 315-675-8319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number467769-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: