Provider Demographics
NPI:1336287663
Name:SCHAEFER, LYNN ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:ANNE
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 CAMBRIA RD
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-6506
Mailing Address - Country:US
Mailing Address - Phone:516-572-6835
Mailing Address - Fax:
Practice Address - Street 1:1670 OLD COUNTRY RD
Practice Address - Street 2:STE 117
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-5020
Practice Address - Country:US
Practice Address - Phone:516-572-6835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015824-1103TC0700X, 103TA0700X, 103TR0400X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation