Provider Demographics
NPI:1982716684
Name:SCHNEIDER, MARK GLENN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:GLENN
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CHERRY CT
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND MILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10930-2800
Mailing Address - Country:US
Mailing Address - Phone:845-926-1775
Mailing Address - Fax:
Practice Address - Street 1:VA HUDSON VALLEY HEALTH CARE SYSTEM
Practice Address - Street 2:ROUTE 9D
Practice Address - City:CASTLE POINT
Practice Address - State:NY
Practice Address - Zip Code:12511
Practice Address - Country:US
Practice Address - Phone:845-831-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016690103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical