Provider Demographics
NPI:1689924128
Name:TAH, SCHNIEDER TAH
Entity Type:Individual
Prefix:
First Name:SCHNIEDER
Middle Name:TAH
Last Name:TAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6856 EASTERN AVE NW
Mailing Address - Street 2:376-D
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-2165
Mailing Address - Country:US
Mailing Address - Phone:202-450-2124
Mailing Address - Fax:202-450-2125
Practice Address - Street 1:6856 EASTERN AVE NW
Practice Address - Street 2:376-D
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-2165
Practice Address - Country:US
Practice Address - Phone:202-450-2124
Practice Address - Fax:202-450-2125
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide