Provider Demographics
NPI:1609199983
Name:SCHNEIDER, GINA MARIE
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:MARIE
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 LONGCREEK DR
Mailing Address - Street 2:
Mailing Address - City:BURNT HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:12027-9578
Mailing Address - Country:US
Mailing Address - Phone:518-399-6351
Mailing Address - Fax:
Practice Address - Street 1:30 LONGCREEK DR
Practice Address - Street 2:
Practice Address - City:BURNT HILLS
Practice Address - State:NY
Practice Address - Zip Code:12027-9578
Practice Address - Country:US
Practice Address - Phone:518-399-6351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-01
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY34402183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist