Healthcare Provider Details

I. General information

NPI: 1710395694
Provider Name (Legal Business Name): ROSEMARIE LIWANAG-SCHAEFER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2014
Last Update Date: 07/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 LILLIAN PL
FARMINGDALE NY
11735-2812
US

IV. Provider business mailing address

27 LILLIAN PL
FARMINGDALE NY
11735-2812
US

V. Phone/Fax

Practice location:
  • Phone: 516-586-5421
  • Fax: 516-586-5421
Mailing address:
  • Phone: 516-586-5421
  • Fax: 516-586-5421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number360204-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: