Provider Demographics
NPI:1386737658
Name:SCHNEEBAUM, CARY (MD)
Entity type:Individual
Prefix:DR
First Name:CARY
Middle Name:
Last Name:SCHNEEBAUM
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 1:155 5TH AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-6802
Mailing Address - Country:US
Mailing Address - Phone:212-741-6100
Mailing Address - Fax:212-741-6667
Practice Address - Street 1:155 5TH AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6802
Practice Address - Country:US
Practice Address - Phone:212-741-6100
Practice Address - Fax:212-741-6667
Is Sole Proprietor?:No
Enumeration Date:2006-10-01
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY154194207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01546661Medicaid
NY01546661Medicaid