Provider Demographics
NPI:1639101322
Name:SCHAFFER, PATTI LORAINE (PA)
Entity Type:Individual
Prefix:
First Name:PATTI
Middle Name:LORAINE
Last Name:SCHAFFER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 PLEASANT STREET
Mailing Address - Street 2:EMERGENCY DEPT
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-7539
Mailing Address - Country:US
Mailing Address - Phone:603-227-7000
Mailing Address - Fax:603-230-7218
Practice Address - Street 1:100 MCGREGOR ST
Practice Address - Street 2:EMERGENCY DEPT
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3730
Practice Address - Country:US
Practice Address - Phone:603-663-6472
Practice Address - Fax:603-663-6645
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAAP2136363AS0400X
NH0515363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30333102Medicaid
NHAP216801Medicare PIN
NHAP216804Medicare PIN
MAQ19911Medicare UPIN
MAAP2794Medicare ID - Type Unspecified