Healthcare Provider Details

I. General information

NPI: 1942734793
Provider Name (Legal Business Name): JEFFREY SCHAETZLE M. ED, BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2017
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 E CITY AVE # 2132
BALA CYNWYD PA
19004-2421
US

IV. Provider business mailing address

12 N BRITTON RD
SPRINGFIELD PA
19064-1705
US

V. Phone/Fax

Practice location:
  • Phone: 609-331-9043
  • Fax:
Mailing address:
  • Phone: 215-620-2637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-17-25744
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: