Provider Demographics
NPI:1790278901
Name:SCHNEIDER, ERIC G (MED, LMHC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:G
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:MED, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W 55TH ST APT 12X
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-5170
Mailing Address - Country:US
Mailing Address - Phone:917-224-3004
Mailing Address - Fax:
Practice Address - Street 1:300 W 55TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5151
Practice Address - Country:US
Practice Address - Phone:917-224-3004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-12
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0082251101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health