Provider Demographics
NPI:1881864254
Name:SCHAEFFER, ROBERT (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:SCHAEFFER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:
Other - Last Name:SCHAEFFER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:125 EMERSON AVE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-1220
Mailing Address - Country:US
Mailing Address - Phone:516-358-7514
Mailing Address - Fax:
Practice Address - Street 1:125 EMERSON AVE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-1220
Practice Address - Country:US
Practice Address - Phone:516-775-2272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-02
Last Update Date:2008-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038673122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist