MEDICARE: SCHNITZER ASSOCIATES, INCORPORATED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0855X	Adolescent and Children Mental Health Clinic/Center

General Provider Information

NPI Number	:	1134778145
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHNITZER ASSOCIATES, INCORPORATED

Provider Business Mailing Address
First Line	:	127 CONCORD AVE
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02421-8203
Country	:	US
Telephone Number	:	781-504-1374
Fax Number	:	781-862-5666

Provider Business Practice Location Address
First Line	:	127 CONCORD AVE
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02421-8203
Country	:	US
Telephone Number	:	781-504-1374
Fax Number	:	781-862-5666

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JEFFREY HOLDEN SCHNITZER
Credential	:	ED.D. MA LSP #253541
Telephone Number	:	781-504-1374

Provider Enumeration Date	:	09/11/2019
Last Update Date	:	09/11/2019

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