Healthcare Provider Details

I. General information

NPI: 1083649263
Provider Name (Legal Business Name): BENJAMIN M SCHAEFER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 12/26/2024
Certification Date: 12/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6511 SPRING BROOK AVE STE 1006
RHINEBECK NY
12572-3709
US

IV. Provider business mailing address

1 COLUMBIA ST 200
POUGHKEEPSIE NY
12601-3924
US

V. Phone/Fax

Practice location:
  • Phone: 845-876-0508
  • Fax: 845-876-0405
Mailing address:
  • Phone: 845-473-1188
  • Fax: 845-485-8937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License Number270188
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number270188
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number270188
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: