Provider Demographics
NPI:1710200019
Name:SHNEYDER, ELLA (RPH)
Entity type:Individual
Prefix:MRS
First Name:ELLA
Middle Name:
Last Name:SHNEYDER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:ELLA
Other - Middle Name:
Other - Last Name:KRAVTSOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:2701 NECK RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-5023
Mailing Address - Country:US
Mailing Address - Phone:718-646-4733
Mailing Address - Fax:
Practice Address - Street 1:424 BRIGHTON BEACH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6457
Practice Address - Country:US
Practice Address - Phone:718-332-5881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI052793-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist