Provider Demographics
NPI:1679642458
Name:SCHAEFER & ASSOCIATES MANAGEMENT LLC
Entity Type:Organization
Organization Name:SCHAEFER & ASSOCIATES MANAGEMENT LLC
Other - Org Name:SCHAEFER AND ASSOCIATES EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SOWINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-251-2020
Mailing Address - Street 1:N86W16275 APPLETON AVE
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-2931
Mailing Address - Country:US
Mailing Address - Phone:262-251-2020
Mailing Address - Fax:262-251-5730
Practice Address - Street 1:N86W16275 APPLETON AVE
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-2931
Practice Address - Country:US
Practice Address - Phone:262-251-2020
Practice Address - Fax:262-251-5730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2864-035152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI4966820001Medicare NSC
WI4966820001Medicare PIN