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NPI Code Detail

MEDICARE: MARY T STODDARD SCHNEIDER

MEDICARE: MARY T STODDARD SCHNEIDER
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
1235Z00000XSpeech-Language Pathologist004514-1NY

General Provider Information

NPI Number : 1407390412
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY T STODDARD SCHNEIDER
Provider Business Mailing Address
First Line : 555 PAGE AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10307-2033
Country : US
Telephone Number : 718-697-3760
Fax Number :
Provider Business Practice Location Address
First Line : 555 PAGE AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10307-2033
Country : US
Telephone Number : 718-697-3760
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2016
Last Update Date : 12/09/2016

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Directions to “ MARY T STODDARD SCHNEIDER ” Practice Location

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