Healthcare Provider Details

I. General information

NPI: 1538352927
Provider Name (Legal Business Name): MARYANN B. SCHAEFER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2007
Last Update Date: 08/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FIVE TRAVERS STREET
MANHASSET NY
11030
US

IV. Provider business mailing address

FIVE TRAVERS STREET
MANHASSET NY
11030
US

V. Phone/Fax

Practice location:
  • Phone: 516-627-1145
  • Fax: 516-869-9155
Mailing address:
  • Phone: 516-627-1145
  • Fax: 516-869-9155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberNYS 000592-1
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: