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NPI Code Detail

MEDICARE: DR. MARY C. SCHNEIDERMAN O.D.

MEDICARE:  DR. MARY C. SCHNEIDERMAN  O.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
1152W00000XOptometrist1526CO

General Provider Information

NPI Number : 1982671327
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY C. SCHNEIDERMAN O.D.
Provider Business Mailing Address
First Line : 8230 CANDLEFLOWER CIR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-5754
Country : US
Telephone Number : 719-594-4914
Fax Number :
Provider Business Practice Location Address
First Line : 5755 N ACADEMY BLVD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-3684
Country : US
Telephone Number : 719-548-8717
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2006
Last Update Date : 07/08/2007

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