Healthcare Provider Details

I. General information

NPI: 1285772111
Provider Name (Legal Business Name): STEPHEN MATTHEW SCHNEIDER PA C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 12/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34TH STREET AND CIVIC CENTER BLVD 3RD FLOOR WOOD
PHILADEPHIA PA
19104-4399
US

IV. Provider business mailing address

847 EASTON RD SUITE 2500
WARRINGTON PA
18976-2906
US

V. Phone/Fax

Practice location:
  • Phone: 215-590-2775
  • Fax: 267-426-7335
Mailing address:
  • Phone: 215-918-5775
  • Fax: 215-918-5776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMA052639
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: