Provider Demographics
NPI:1255872446
Name:SCHNEIDER, JASON ANDREW (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:ANDREW
Last Name:SCHNEIDER
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 1:263 FARMINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-8085
Mailing Address - Country:US
Mailing Address - Phone:860-679-2792
Mailing Address - Fax:860-679-1494
Practice Address - Street 1:263 FARMINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-8085
Practice Address - Country:US
Practice Address - Phone:860-679-2792
Practice Address - Fax:860-679-1494
Is Sole Proprietor?:No
Enumeration Date:2017-03-20
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.142174207V00000X
CT077278207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology