Provider Demographics
NPI:1003876772
Name:SCHAEFER, STEVEN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:DAVID
Last Name:SCHAEFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:STEVEN
Other - Middle Name:DAVID
Other - Last Name:SCHAEFER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:110 E 59TH ST
Mailing Address - Street 2:SUITES 10A AND 8C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1304
Mailing Address - Country:US
Mailing Address - Phone:212-434-4500
Mailing Address - Fax:212-434-4597
Practice Address - Street 1:110 E 59TH ST
Practice Address - Street 2:SUITES 8C AND 10A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1304
Practice Address - Country:US
Practice Address - Phone:212-434-4500
Practice Address - Fax:212-434-4580
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY188589174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01355426Medicaid
NY47K781Medicare ID - Type Unspecified
NY01355426Medicaid