Provider Demographics
NPI:1598105884
Name:SCHAFER, ALLISON MARGARET (DO)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARGARET
Last Name:SCHAFER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-4038
Mailing Address - Country:US
Mailing Address - Phone:860-679-6600
Mailing Address - Fax:860-679-6608
Practice Address - Street 1:263 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-4038
Practice Address - Country:US
Practice Address - Phone:860-679-6600
Practice Address - Fax:860-679-6608
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO2966207Q00000X, 207QS0010X
CT061655207Q00000X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNDO2966OtherTN MEDICAL LICENSE