MEDICARE: ANDREW SCHAEFER OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	021303-1	NY
2	225X00000X	Occupational Therapist	0T18283	FL

General Provider Information

NPI Number	:	1982145272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW SCHAEFER OTR/L

Provider Business Mailing Address
First Line	:	1531 YORK AVE APT 1B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-7061
Country	:	US
Telephone Number	:	239-564-2588
Fax Number	:

Provider Business Practice Location Address
First Line	:	1531 YORK AVE APT 1B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-7061
Country	:	US
Telephone Number	:	239-564-2588
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2017
Last Update Date	:	03/20/2017

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