Provider Demographics
NPI:1619916244
Name:SCHNEIDER, WAYNE (MD)
Entity Type:Individual
Prefix:
First Name:WAYNE
Middle Name:
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 S SHORE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MARMORA
Mailing Address - State:NJ
Mailing Address - Zip Code:08223-1200
Mailing Address - Country:US
Mailing Address - Phone:609-390-0882
Mailing Address - Fax:609-390-3511
Practice Address - Street 1:210 S SHORE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MARMORA
Practice Address - State:NJ
Practice Address - Zip Code:08223-1200
Practice Address - Country:US
Practice Address - Phone:609-390-0882
Practice Address - Fax:609-390-3511
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06303400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1088194OtherHORIZON NJ HEALTH #
NJ2K8765OtherHEALTHNET #
NJP818448OtherOXFORD #
NJP00232638OtherRAILROAD MCR #
NJ22850OtherUHP #
NJ901455OtherAETNA PPO #
NJ1887184OtherFIRST HEALTH #
NJ0521648000OtherAMERIHEALTH #
NJ0805351OtherAETNA HMO #
NJ63915OtherAMERIGROUP #
NJ2K8765OtherHEALTHNET #
NJ901455OtherAETNA PPO #