MEDICARE: PETER JOHN SCHNORR

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207R00000X	Internal Medicine Physician	291176	MA
3	207RP1001X	Pulmonary Disease Physician	291176	MA

General Provider Information

NPI Number	:	1376002618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER JOHN SCHNORR

Provider Business Mailing Address
First Line	:	725 ALBANY ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02118-2526
Country	:	US
Telephone Number	:	617-414-5951
Fax Number	:	617-414-9251

Provider Business Practice Location Address
First Line	:	725 ALBANY ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02118-2526
Country	:	US
Telephone Number	:	617-414-5951
Fax Number	:	617-414-9251

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2019
Last Update Date	:	05/26/2026

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