Provider Demographics
NPI:1902870207
Name:SCHAFFER, SONJA GRETA (MD)
Entity type:Individual
Prefix:MRS
First Name:SONJA
Middle Name:GRETA
Last Name:SCHAFFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:NEW CUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17070-1120
Mailing Address - Country:US
Mailing Address - Phone:717-774-7351
Mailing Address - Fax:717-774-7529
Practice Address - Street 1:1515 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:NEW CUMBERLAND
Practice Address - State:PA
Practice Address - Zip Code:17070-1120
Practice Address - Country:US
Practice Address - Phone:717-774-7351
Practice Address - Fax:717-774-7529
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038842L2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1741759Medicaid
PA1741759Medicaid
PA023082Medicare ID - Type Unspecified