Provider Demographics
NPI:1124137948
Name:SCHNEIDER, ADAM JASON (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:JASON
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 1:380 N BROADWAY STE 307
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-2109
Mailing Address - Country:US
Mailing Address - Phone:516-367-8040
Mailing Address - Fax:516-333-6160
Practice Address - Street 1:380 N BROADWAY STE 307
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-2109
Practice Address - Country:US
Practice Address - Phone:516-367-8040
Practice Address - Fax:516-333-6160
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1988712084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
198871-A15OtherHEALTH FIRST
202545554OtherCNA
3099052OtherGHI
202545554OtherTAX ID
3854838OtherHMO
4C8538OtherHEALTHNET (PHS)
600N91OtherEMPIRE BCBS
7206299OtherHMO PPO
010198871NY01OtherANTHEM
202545554OtherEMPIRE GOV (UHC)
196919POtherHIP
198871OtherHIP HEALTHCARE PART.
202545554OtherHORIZON
202545554OtherBEECH STREET
5901563OtherPPO
MCA140402OtherAMERICHOICE
NY01749664Medicaid
202545554OtherCHUBB
MCA140402OtherAMERICHOICE
G48824Medicare UPIN