Provider Demographics
NPI:1124876156
Name:SCHNEEWEISS, MIREL (PA)
Entity type:Individual
Prefix:
First Name:MIREL
Middle Name:
Last Name:SCHNEEWEISS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 ANDERSON RD
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3717
Mailing Address - Country:US
Mailing Address - Phone:845-548-9609
Mailing Address - Fax:
Practice Address - Street 1:29 ANDERSON RD
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3717
Practice Address - Country:US
Practice Address - Phone:845-548-9609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031718363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical