Provider Demographics
NPI:1922445402
Name:SCHNEIDER, ALINA MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:ALINA
Middle Name:MARIE
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ALINA
Other - Middle Name:MARIE
Other - Last Name:MAZZOTTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1420 MAIN ST STE 124
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-3110
Mailing Address - Country:US
Mailing Address - Phone:860-430-5300
Mailing Address - Fax:860-362-4006
Practice Address - Street 1:1420 MAIN ST STE 124
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-3110
Practice Address - Country:US
Practice Address - Phone:860-430-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-24
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12.005746363L00000X, 363L00000X
CT5746363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1922445402OtherNPI