Provider Demographics
NPI:1811980535
Name:SCHNEIDER, DIANE L (MPT)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:L
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:PA
Mailing Address - Zip Code:16346-0248
Mailing Address - Country:US
Mailing Address - Phone:814-670-0534
Mailing Address - Fax:814-670-0653
Practice Address - Street 1:3232 STATE HWY 257
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:PA
Practice Address - Zip Code:16346-2454
Practice Address - Country:US
Practice Address - Phone:814-676-6675
Practice Address - Fax:814-676-6886
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT014024L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101662068 0003Medicaid
PA101662068 0004Medicaid
PA101662068 0006Medicaid
PA101662068 0007Medicaid
PA101662068 0001Medicaid
PA101662068 0002Medicaid
PA101662068 0005Medicaid
PA101662068 0007Medicaid
PA248864Medicare UPIN
PAP00213586Medicare UPIN
PA918874Medicare UPIN
PA101662068 0001Medicaid