Provider Demographics
NPI:1528649902
Name:SCHNEIDER, PAUL (PA-C)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 MONSIGNOR OBRIEN HWY APT 204
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02141-2280
Mailing Address - Country:US
Mailing Address - Phone:774-270-1395
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:WHITE 1
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-724-4100
Practice Address - Fax:617-726-7415
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-18
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant