Provider Demographics
NPI:1316976988
Name:SCHNEIDER, JASON L (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:L
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1231 DEER PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-3104
Mailing Address - Country:US
Mailing Address - Phone:631-667-0388
Mailing Address - Fax:631-277-3750
Practice Address - Street 1:1231 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-3104
Practice Address - Country:US
Practice Address - Phone:631-667-0388
Practice Address - Fax:631-968-7705
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2019-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1922832086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01580872Medicaid
NY192283OtherLICENSE
NY192283OtherLICENSE
NY01580872Medicaid