1053301028 NPI number — SARAH C SCHNEIDER MD

Table of content: SARAH C SCHNEIDER MD (NPI 1053301028)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053301028 NPI number — SARAH C SCHNEIDER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHNEIDER
Provider First Name:
SARAH
Provider Middle Name:
C
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CARLSON
Provider Other First Name:
SARAH
Provider Other Middle Name:
R
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1053301028
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
75 WASHINGTON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORWELL
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02061
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-878-5200
Provider Business Mailing Address Fax Number:
781-681-9901

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
75 WASHINGTON ST
Provider Second Line Business Practice Location Address:
SOUTH SHORE MEDICAL CENTER
Provider Business Practice Location Address City Name:
NORWELL
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02061-9147
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-878-5200
Provider Business Practice Location Address Fax Number:
781-681-9901
Provider Enumeration Date:
10/21/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  217226 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 042297845 . This is a "PRIVATE HEALTHCARE SYSTEM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 7730438 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 042297845 . This is a "DOC FIRST" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 217226 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 59769 . This is a "FALLON" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 042297845 . This is a "TRICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 042297845 . This is a "GREAT WEST HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: J26449 . This is a "BCBS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 042297845 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 206560 . This is a "HVD PILGRIM HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 042297845 . This is a "HCVM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 042297845 . This is a "GIC UNICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2024331 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7505603 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 030355 . This is a "NEIGHBORHOOD HLTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".