Provider Demographics
NPI:1033935739
Name:SCHAFFER, JOSHUA JOSEPH
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:JOSEPH
Last Name:SCHAFFER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CLINTON ST APT 312
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-3290
Mailing Address - Country:US
Mailing Address - Phone:949-370-2355
Mailing Address - Fax:
Practice Address - Street 1:1200 CLINTON ST APT 312
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-3290
Practice Address - Country:US
Practice Address - Phone:949-370-2355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY432990363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner