Provider Demographics
NPI:1104487305
Name:SCHAEFER, ROBERT J JR
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:J
Last Name:SCHAEFER
Suffix:JR
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 1:4003 HARLEM RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4707
Mailing Address - Country:US
Mailing Address - Phone:716-839-1110
Mailing Address - Fax:716-839-1178
Practice Address - Street 1:4003 HARLEM RD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14226-4707
Practice Address - Country:US
Practice Address - Phone:716-839-1110
Practice Address - Fax:716-839-1178
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY156FX1800XOtherOPTICIAN