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NPI Code Detail

MEDICARE: DR. C. SUZANNE SCHNEIDER PH.D.

MEDICARE:  DR. C. SUZANNE  SCHNEIDER  PH.D.
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
1103T00000XPsychologistPS004724LPA

General Provider Information

NPI Number : 1811066756
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. C. SUZANNE SCHNEIDER PH.D.
Provider Business Mailing Address
First Line : 3324 MIDVALE AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19129-1404
Country : US
Telephone Number : 215-849-5077
Fax Number : 215-849-8787
Provider Business Practice Location Address
First Line : 3324 MIDVALE AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19129-1404
Country : US
Telephone Number : 215-849-5077
Fax Number : 215-849-8787
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 07/16/2007

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