Healthcare Provider Details

I. General information

NPI: 1336287663
Provider Name (Legal Business Name): LYNN ANNE SCHAEFER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 10/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 OLD COUNTRY RD STE 117
PLAINVIEW NY
11803-5020
US

IV. Provider business mailing address

75 CAMBRIA RD
SYOSSET NY
11791-6506
US

V. Phone/Fax

Practice location:
  • Phone: 516-572-6835
  • Fax:
Mailing address:
  • Phone: 516-572-6835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number015824-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number015824-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number015824-1
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number015824-1
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: