Provider Demographics
NPI:1992001598
Name:SCHAEFER, MAURA N (MA, SLP, TSHH)
Entity Type:Individual
Prefix:MRS
First Name:MAURA
Middle Name:N
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:MA, SLP, TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 AUDREY DR
Mailing Address - Street 2:
Mailing Address - City:LIDO BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-4803
Mailing Address - Country:US
Mailing Address - Phone:516-992-0978
Mailing Address - Fax:
Practice Address - Street 1:137 AUDREY DR
Practice Address - Street 2:
Practice Address - City:LIDO BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-4803
Practice Address - Country:US
Practice Address - Phone:516-992-0978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY58013158235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist