Provider Demographics
NPI:1205851524
Name:SCHAFER, WILLIAM R (PA)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:SCHAFER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:2546 BALLTOWN RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-1079
Mailing Address - Country:US
Mailing Address - Phone:518-377-8198
Mailing Address - Fax:518-377-0620
Practice Address - Street 1:22 RIVERWIND DR
Practice Address - Street 2:
Practice Address - City:REXFORD
Practice Address - State:NY
Practice Address - Zip Code:12148-1222
Practice Address - Country:US
Practice Address - Phone:518-605-1520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY003366363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant