Provider Demographics
NPI:1124177399
Name:SCHAEFER, DEBORAH ANN (DO)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 ROUTE 25A
Mailing Address - Street 2:
Mailing Address - City:SHOREHAM
Mailing Address - State:NY
Mailing Address - Zip Code:11786-1389
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:45 ROUTE 25A
Practice Address - Street 2:
Practice Address - City:SHOREHAM
Practice Address - State:NY
Practice Address - Zip Code:11786-1389
Practice Address - Country:US
Practice Address - Phone:631-585-5858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1939902207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
364487963OtherMAGNACARE
133507POtherHIP
3C3473OtherHEALTHNET
5204A1OtherBCBS
5996891OtherGHI
1201504OtherFIRST HEALTH
364487963OtherEMP GOVT
91676OtherVYTRA
98367OtherAETNA
364487963OtherONE HEALTH PLAN
SD3990OtherATLANTIS
364487963OtherMULTIPLAN
AA51005EOtherMDNY
364487963OtherSELECT PRO
8794391OtherCIGNA
1394613OtherUHC
364487963OtherDEVON
P404828OtherOXFORD