Provider Demographics
NPI:1366617441
Name:SCHAFFER, BURTON (MD)
Entity type:Individual
Prefix:DR
First Name:BURTON
Middle Name:
Last Name:SCHAFFER
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 1:1703 SARATOGA CT
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2869
Mailing Address - Country:US
Mailing Address - Phone:856-782-1939
Mailing Address - Fax:856-782-1939
Practice Address - Street 1:1703 SARATOGA CT
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2869
Practice Address - Country:US
Practice Address - Phone:856-782-1939
Practice Address - Fax:856-782-1939
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MAO1852600146N00000X, 261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic