Basic Information
| Provider Information | |||||||||
| NPI: | 1053301028 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHNEIDER | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CARLSON | ||||||||
| OtherFirstName: | SARAH | ||||||||
| OtherMiddleName: | R | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 75 WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02061 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818785200 | ||||||||
| FaxNumber: | 7816819901 | ||||||||
| Practice Location | |||||||||
| Address1: | 75 WASHINGTON ST | ||||||||
| Address2: | SOUTH SHORE MEDICAL CENTER | ||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020619147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818785200 | ||||||||
| FaxNumber: | 7816819901 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2005 | ||||||||
| LastUpdateDate: | 02/10/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | |||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 217226 | MA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 042297845 | 01 | MA | PRIVATE HEALTHCARE SYSTEM | OTHER | 7730438 | 01 | MA | CIGNA | OTHER | 042297845 | 01 | MA | DOC FIRST | OTHER | 217226 | 01 | MA | TUFTS | OTHER | 59769 | 01 | MA | FALLON | OTHER | 042297845 | 01 | MA | TRICARE | OTHER | 042297845 | 01 | MA | GREAT WEST HEALTH CARE | OTHER | J26449 | 01 | MA | BCBS | OTHER | 042297845 | 01 | MA | UNITED HEALTH CARE | OTHER | 206560 | 01 | MA | HVD PILGRIM HEALTH CARE | OTHER | 042297845 | 01 | MA | HCVM | OTHER | 042297845 | 01 | MA | GIC UNICARE | OTHER | 2024331 | 05 | MA | MEDICAID | 7505603 | 01 | MA | AETNA | OTHER | 030355 | 01 | MA | NEIGHBORHOOD HLTH PLAN | OTHER |