Provider Demographics
NPI:1386734325
Name:SCHAEFFER, MICHAEL ERIC (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ERIC
Last Name:SCHAEFFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 14890
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12212-4890
Mailing Address - Country:US
Mailing Address - Phone:518-525-5634
Mailing Address - Fax:
Practice Address - Street 1:1301 RIVER ST STE 204
Practice Address - Street 2:
Practice Address - City:VALATIE
Practice Address - State:NY
Practice Address - Zip Code:12184-9696
Practice Address - Country:US
Practice Address - Phone:518-392-8600
Practice Address - Fax:518-392-8601
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208387207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01918996Medicaid
NYRB7964Medicare PIN
NY12S78NW001Medicare PIN
NYG77340Medicare UPIN