Provider Demographics
NPI:1114056744
Name:SCHAEFFER, SCOTT THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:THOMAS
Last Name:SCHAEFFER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 E MAIN ST
Mailing Address - Street 2:SUITE 3B
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3028
Mailing Address - Country:US
Mailing Address - Phone:914-244-6202
Mailing Address - Fax:914-244-6396
Practice Address - Street 1:359 E MAIN ST
Practice Address - Street 2:SUITE 3B
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3028
Practice Address - Country:US
Practice Address - Phone:914-244-6202
Practice Address - Fax:914-244-6396
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008660111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX5B081Medicare ID - Type UnspecifiedCHIROPRACTIC PROVIDER