Provider Demographics
NPI:1760767065
Name:SCHAFFER, SYLVAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:SYLVAN
Middle Name:
Last Name:SCHAFFER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13844 JEWEL AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1933
Mailing Address - Country:US
Mailing Address - Phone:718-969-0549
Mailing Address - Fax:718-591-0084
Practice Address - Street 1:13844 JEWEL AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1933
Practice Address - Country:US
Practice Address - Phone:718-969-0549
Practice Address - Fax:718-591-0084
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008283103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical