Provider Demographics
NPI:1477640126
Name:SCHNEIDER, ERIC D (PT)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:D
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 W PADONIA RD
Mailing Address - Street 2:STEC-132
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-2226
Mailing Address - Country:US
Mailing Address - Phone:410-560-5944
Mailing Address - Fax:410-560-6944
Practice Address - Street 1:22 W PADONIA RD
Practice Address - Street 2:SUITE C-132
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-2226
Practice Address - Country:US
Practice Address - Phone:410-560-5944
Practice Address - Fax:410-560-6944
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18780225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD205N 209GMedicare PIN