Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 021761 | NY |
Y | 103TC0700X | Clinical Psychologist | 021761 | NY |
N | 103TC1900X | Counseling Psychologist | 021761 | NY |
N | 103TH0004X | Health Psychologist | 021761 | NY |
NPI | 1265989628 |
---|---|
Provider Name | Dr. Charles Schaeffer |
First Address | Brooklyn, NY 11215-6621 |
Second Address | New York, NY 10011-9126 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2016 |
Last Update Date | 02/09/2016 |