Provider Demographics
NPI:1528378387
Name:SCHNEIDER, TERRY (OPTICIAN)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-2314
Mailing Address - Country:US
Mailing Address - Phone:914-948-1700
Mailing Address - Fax:914-948-7078
Practice Address - Street 1:161 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-2314
Practice Address - Country:US
Practice Address - Phone:914-948-1700
Practice Address - Fax:914-948-7078
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCUW9603156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician