Shaefer, Jeffry R

Shaefer, Jeffry R is an individual health care provider with primary practice located at 188 Longwood Avenue Harvard Faculty Group Practice, Boston MA 02115. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Shaefer, Jeffry R can be contacted via phone (617) 432-3153.

Contact Information

Primary practice address
188 Longwood Avenue Harvard Faculty Group Practice Boston MA 02115
Phone: (617) 432-3153
Fax: (617) 498-1205
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 15402 Massachusetts

Profile Details

NPI number 1306822606
LBN Legal business name Shaefer, Jeffry R
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2005
Last updated Oct 2nd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306822606 NPPES
Massachusetts Other 015402 TUFTS HEALTH PLAN
Massachusetts MEDICAID 0282138 TUFTS HEALTH PLAN

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