Provider Demographics
NPI:1124268651
Name:SCHAFFER, DEBRA ANNE (NP)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANNE
Last Name:SCHAFFER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HARRISON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:NY
Mailing Address - Zip Code:13790-3100
Mailing Address - Country:US
Mailing Address - Phone:607-763-6850
Mailing Address - Fax:607-763-5201
Practice Address - Street 1:30 HARRISON ST STE 100
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:NY
Practice Address - Zip Code:13790-3100
Practice Address - Country:US
Practice Address - Phone:607-763-6850
Practice Address - Fax:607-763-6703
Is Sole Proprietor?:No
Enumeration Date:2009-02-24
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305091363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA1006Medicare PIN