Provider Demographics
NPI:1962784512
Name:SCHAEFFER, DANIEL A
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:A
Last Name:SCHAEFFER
Suffix:
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 1:161 NARRAGANSETT TRL
Mailing Address - Street 2:
Mailing Address - City:MEDFORD LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-1708
Mailing Address - Country:US
Mailing Address - Phone:856-745-4435
Mailing Address - Fax:
Practice Address - Street 1:321 NORRISTOWN RD STE 220
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-2793
Practice Address - Country:US
Practice Address - Phone:866-736-9654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA00954700225100000X
PAPT013625L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist