Provider Demographics
NPI:1821178104
Name:SCHAEFER, CRAIG J (DMD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:J
Last Name:SCHAEFER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800A 5TH AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-7215
Mailing Address - Country:US
Mailing Address - Phone:212-754-0880
Mailing Address - Fax:
Practice Address - Street 1:800A 5TH AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-7215
Practice Address - Country:US
Practice Address - Phone:212-754-0880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY288821223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics