1619916244 NPI number — WAYNE SCHNEIDER M.D.

Table of content: WAYNE SCHNEIDER M.D. (NPI 1619916244)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619916244 NPI number — WAYNE SCHNEIDER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHNEIDER
Provider First Name:
WAYNE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619916244
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
210 S SHORE RD
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
MARMORA
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08223-1200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-390-0882
Provider Business Mailing Address Fax Number:
609-390-3511

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
210 S SHORE RD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
MARMORA
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08223-1200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-390-0882
Provider Business Practice Location Address Fax Number:
609-390-3511
Provider Enumeration Date:
06/06/2006

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: 207Q00000X , with the licence number:  25MA06303400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1088194 . This is a "HORIZON NJ HEALTH #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2K8765 . This is a "HEALTHNET #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P818448 . This is a "OXFORD #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P00232638 . This is a "RAILROAD MCR #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 22850 . This is a "UHP #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 901455 . This is a "AETNA PPO #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1887184 . This is a "FIRST HEALTH #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0521648000 . This is a "AMERIHEALTH #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0805351 . This is a "AETNA HMO #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 63915 . This is a "AMERIGROUP #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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