MEDICARE: GABRIELLE SCHNEIDER PT

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	225100000X	Physical Therapist	039040	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	039040	OTHER	NY	NY STATE LICENSE

General Provider Information

NPI Number	:	1568838332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELLE SCHNEIDER PT

Provider Business Mailing Address
First Line	:	584 BROADWAY
Second Line	:	SUITE 710
City	:	NEW YORK
State	:	NY
Zip	:	10012-5242
Country	:	US
Telephone Number	:	212-941-0503
Fax Number	:	212-941-6195

Provider Business Practice Location Address
First Line	:	584 BROADWAY
Second Line	:	SUITE 710
City	:	NEW YORK
State	:	NY
Zip	:	10012-5242
Country	:	US
Telephone Number	:	212-941-0503
Fax Number	:	212-941-6195

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

Provider Enumeration Date	:	08/17/2015
Last Update Date	:	08/17/2015

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Directions to “ GABRIELLE SCHNEIDER PT” Practice Location

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