Provider Demographics
NPI:1760151476
Name:STEPHEN G. SCHNEIDER, PHD
Entity Type:Organization
Organization Name:STEPHEN G. SCHNEIDER, PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIREOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:212-252-2850
Mailing Address - Street 1:1430 BROADWAY RM 1510
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-3368
Mailing Address - Country:US
Mailing Address - Phone:212-262-2850
Mailing Address - Fax:212-262-2858
Practice Address - Street 1:1430 BROADWAY RM 1510
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-3368
Practice Address - Country:US
Practice Address - Phone:212-262-2850
Practice Address - Fax:212-262-2858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY017947OtherLICENSE