Provider Demographics
NPI:1801879895
Name:SCHNEIDERMAN, TODD A (MD)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:A
Last Name:SCHNEIDERMAN
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 1:215 UNION AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-3063
Mailing Address - Country:US
Mailing Address - Phone:908-725-5050
Mailing Address - Fax:908-927-1133
Practice Address - Street 1:215 UNION AVE
Practice Address - Street 2:SUITE C
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-3063
Practice Address - Country:US
Practice Address - Phone:908-725-5050
Practice Address - Fax:908-927-1133
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ07416600207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ080700Medicare ID - Type Unspecified