Provider Demographics
NPI:1518142538
Name:LOREN J. SCHNEIDER, DPM PC
Entity Type:Organization
Organization Name:LOREN J. SCHNEIDER, DPM PC
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE BILLING
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMERCHANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-646-5153
Mailing Address - Street 1:483 MIDDLE TPKE W
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-3863
Mailing Address - Country:US
Mailing Address - Phone:860-646-5153
Mailing Address - Fax:860-647-0449
Practice Address - Street 1:483 MIDDLE TPKE W
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-3863
Practice Address - Country:US
Practice Address - Phone:860-646-5153
Practice Address - Fax:860-647-0449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC02098OtherGROUP
CT4946650001Medicare NSC
CTT23881Medicare UPIN