Provider Demographics
NPI:1760703813
Name:SCHNEIDER, PETER NICHOLAS (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:NICHOLAS
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PETE
Other - Middle Name:
Other - Last Name:SCHNEIDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:355 BARD AVE RM 314
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-1699
Mailing Address - Country:US
Mailing Address - Phone:718-818-4636
Mailing Address - Fax:718-818-2739
Practice Address - Street 1:2421 US ROUTE 1
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-4326
Practice Address - Country:US
Practice Address - Phone:792-297-6767
Practice Address - Fax:732-297-6762
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA12073900208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics