Provider Demographics
NPI:1023525706
Name:SCHAEFER, ZACHARY (BC-HIS)
Entity type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:
Last Name:SCHAEFER
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32930 FOX CHAPPEL LN
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-2336
Mailing Address - Country:US
Mailing Address - Phone:419-656-1900
Mailing Address - Fax:
Practice Address - Street 1:4199 KINROSS LAKES PKWY
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44286-9010
Practice Address - Country:US
Practice Address - Phone:234-400-0201
Practice Address - Fax:234-400-0201
Is Sole Proprietor?:No
Enumeration Date:2018-01-04
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2754237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist