Provider Demographics
NPI:1740428747
Name:OWEN B SCHNEIDER MD LLC
Entity Type:Organization
Organization Name:OWEN B SCHNEIDER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OWEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-834-8251
Mailing Address - Street 1:5 SPANISH COVE RD
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-3815
Mailing Address - Country:US
Mailing Address - Phone:914-834-8251
Mailing Address - Fax:914-834-8563
Practice Address - Street 1:5 SPANISH COVE RD
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-3815
Practice Address - Country:US
Practice Address - Phone:914-834-8251
Practice Address - Fax:914-834-8563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-28
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYMD 1089961261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
B18924Medicare UPIN