Provider Demographics
NPI:1629182548
Name:SCHAFFNER, ADAM DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:DAVID
Last Name:SCHAFFNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 5TH AVE STE 1101
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-4702
Mailing Address - Country:US
Mailing Address - Phone:212-481-6696
Mailing Address - Fax:877-992-0274
Practice Address - Street 1:590 5TH AVE STE 1101
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-4702
Practice Address - Country:US
Practice Address - Phone:212-481-6696
Practice Address - Fax:877-992-0274
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY217426207Y00000X, 207YS0123X, 207YX0007X, 207YX0905X, 2082S0099X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
No2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC160348YT2Medicare PIN
I05323Medicare UPIN
NY7M4791Medicare ID - Type Unspecified
NYA400040926Medicare PIN