Healthcare Provider Details

I. General information

NPI: 1508865486
Provider Name (Legal Business Name): HENRY A SCHAEFFER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 03/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 CLARKSON AVE # 49 DEPARTMENT OF PEDIATRICS, SUNY-DOWNSTATE MEDICAL CENTER
BROOKLYN NY
11203-2012
US

IV. Provider business mailing address

170 RUGBY RD
BROOKLYN NY
11226-4550
US

V. Phone/Fax

Practice location:
  • Phone: 718-270-7289
  • Fax: 718-270-1985
Mailing address:
  • Phone: 718-462-5789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number092456
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: