Provider Demographics
NPI:1851602007
Name:SCHAEFFER, MELISSA LAUREN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:LAUREN
Last Name:SCHAEFFER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:LAUREN
Other - Last Name:GLENWICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:303 E 83RD ST
Mailing Address - Street 2:APT 12A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-4318
Mailing Address - Country:US
Mailing Address - Phone:301-938-5295
Mailing Address - Fax:
Practice Address - Street 1:303 EAST 83RD STREET
Practice Address - Street 2:APT 12A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028
Practice Address - Country:US
Practice Address - Phone:301-938-5295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015536-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics