Provider Demographics
NPI:1407868821
Name:SCHNEIR, JEROME A (DO, MD)
Entity Type:Individual
Prefix:DR
First Name:JEROME
Middle Name:A
Last Name:SCHNEIR
Suffix:
Gender:M
Credentials:DO, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 AUSTIN RD
Mailing Address - Street 2:PO BOX 1650
Mailing Address - City:EAST HAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11937-2090
Mailing Address - Country:US
Mailing Address - Phone:631-329-0897
Mailing Address - Fax:631-329-0897
Practice Address - Street 1:15 TOILSOME LN
Practice Address - Street 2:
Practice Address - City:EAST HAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11937-2469
Practice Address - Country:US
Practice Address - Phone:631-324-1483
Practice Address - Fax:631-329-8958
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY090455208100000X, 208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAS0604834OtherDEA NUMBER
NYAS0604834OtherDEA NUMBER
NYAS0604834OtherDEA NUMBER
NY54-2064998OtherEIN NUMBER