Provider Demographics
NPI:1952701195
Name:SCHAEFFER, BRADLEY (DPM)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:
Last Name:SCHAEFFER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 W 85TH STREET
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-4118
Mailing Address - Country:US
Mailing Address - Phone:212-874-0564
Mailing Address - Fax:212-496-8548
Practice Address - Street 1:1 W 85TH STREET
Practice Address - Street 2:SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-4118
Practice Address - Country:US
Practice Address - Phone:212-874-0564
Practice Address - Fax:212-496-8548
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-25
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00319500213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery