Healthcare Provider Details

I. General information

NPI: 1396891594
Provider Name (Legal Business Name): STEPHEN H. SCHAUER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2007
Last Update Date: 09/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

242 BAYVILLE AVE
BAYVILLE NY
11709-1612
US

IV. Provider business mailing address

242 BAYVILLE AVE
BAYVILLE NY
11709-1612
US

V. Phone/Fax

Practice location:
  • Phone: 516-628-3300
  • Fax:
Mailing address:
  • Phone: 516-628-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX002543
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: