Provider Demographics
NPI:1508865486
Name:SCHAEFFER, HENRY A (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:A
Last Name:SCHAEFFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:170 RUGBY RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-4550
Mailing Address - Country:US
Mailing Address - Phone:718-462-5789
Mailing Address - Fax:
Practice Address - Street 1:450 CLARKSON AVE # 49
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS, SUNY-DOWNSTATE MEDICAL CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2012
Practice Address - Country:US
Practice Address - Phone:718-270-7289
Practice Address - Fax:718-270-1985
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092456208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00149151Medicaid
558461Medicare UPIN