Provider Demographics
NPI:1760524987
Name:SCHNEIDER, JENNIFER HOLLY (MA FAA)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:HOLLY
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:MA FAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 ORCHARD PARK RD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-2671
Mailing Address - Country:US
Mailing Address - Phone:716-712-2000
Mailing Address - Fax:
Practice Address - Street 1:630 ORCHARD PARK RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-2671
Practice Address - Country:US
Practice Address - Phone:716-712-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001749231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00030338001OtherUNIVERA HEALTHCARE
NY00057611002OtherBLUE CROSS OF WNY
NY9290034OtherINDEPENDENT HEALTH
NY00030338001OtherUNIVERA HEALTHCARE
NYP08052Medicare UPIN