Healthcare Provider Details
I. General information
NPI: 1124137948
Provider Name (Legal Business Name): ADAM JASON SCHNEIDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/29/2006
Last Update Date: 07/08/2022
Certification Date: 04/08/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
380 N BROADWAY STE 307
JERICHO NY
11753-2109
US
IV. Provider business mailing address
380 N BROADWAY STE 307
JERICHO NY
11753-2109
US
V. Phone/Fax
- Phone: 516-367-8040
- Fax: 516-333-6160
- Phone: 516-367-8040
- Fax: 516-333-6160
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | 198871 |
| License Number State | NY |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 198871-A15 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | HEALTH FIRST |
| # 2 | |
| Identifier | 202545554 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | CNA |
| # 3 | |
| Identifier | 3099052 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | GHI |
| # 4 | |
| Identifier | 202545554 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | TAX ID |
| # 5 | |
| Identifier | 3854838 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | HMO |
| # 6 | |
| Identifier | 4C8538 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | HEALTHNET (PHS) |
| # 7 | |
| Identifier | 600N91 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | EMPIRE BCBS |
| # 8 | |
| Identifier | 7206299 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | HMO PPO |
| # 9 | |
| Identifier | 010198871NY01 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | ANTHEM |
| # 10 | |
| Identifier | 202545554 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | EMPIRE GOV (UHC) |
| # 11 | |
| Identifier | 196919P |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | HIP |
| # 12 | |
| Identifier | 198871 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | HIP HEALTHCARE PART. |
| # 13 | |
| Identifier | 202545554 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | HORIZON |
| # 14 | |
| Identifier | 202545554 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | BEECH STREET |
| # 15 | |
| Identifier | 5901563 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | PPO |
| # 16 | |
| Identifier | MCA140402 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | AMERICHOICE |
| # 17 | |
| Identifier | 01749664 |
| Identifier Type | MEDICAID |
| Identifier State | NY |
| Identifier Issuer | |
| # 18 | |
| Identifier | 202545554 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | CHUBB |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
