Provider Demographics
NPI:1861477465
Name:SHNAYDER, ERIC (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:SHNAYDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 KIEL AVE
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-2549
Mailing Address - Country:US
Mailing Address - Phone:973-838-7722
Mailing Address - Fax:973-838-3579
Practice Address - Street 1:11 KIEL AVE STE 2
Practice Address - Street 2:
Practice Address - City:KINNELON
Practice Address - State:NJ
Practice Address - Zip Code:07405-2557
Practice Address - Country:US
Practice Address - Phone:973-838-7722
Practice Address - Fax:973-838-3579
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07307900207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8682402Medicaid
H39517Medicare UPIN
NJ8682402Medicaid