Provider Demographics
NPI:1356511968
Name:SCHNEIDER, LORI ANN
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:ANN
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:SCHNEIDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:1042 COUNTY ROUTE 17
Mailing Address - Street 2:
Mailing Address - City:BERNHARDS BAY
Mailing Address - State:NY
Mailing Address - Zip Code:13028-4123
Mailing Address - Country:US
Mailing Address - Phone:315-675-8319
Mailing Address - Fax:
Practice Address - Street 1:1042 COUNTY ROUTE 17
Practice Address - Street 2:
Practice Address - City:BERNHARDS BAY
Practice Address - State:NY
Practice Address - Zip Code:13028-4123
Practice Address - Country:US
Practice Address - Phone:315-675-8319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY467769-1163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02880188Medicaid