Healthcare Provider Details

I. General information

NPI: 1962995803
Provider Name (Legal Business Name): MISS LAUREN N SCHAEFER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2018
Last Update Date: 07/19/2023
Certification Date: 07/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 PASSAIC AVE
FAIRFIELD NJ
07004-3561
US

IV. Provider business mailing address

45 ELM ST
ENGLEWOOD CLIFFS NJ
07632-1509
US

V. Phone/Fax

Practice location:
  • Phone: 973-800-8515
  • Fax:
Mailing address:
  • Phone: 631-942-6462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number41YS01203400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: