Healthcare Provider Details

I. General information

NPI: 1598861668
Provider Name (Legal Business Name): JONATHAN SHEINDLIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 02/22/2024
Certification Date: 11/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3651 BRUCKNER BOULEVARD SUITE 6A
BRONX NY
10461-0396
US

IV. Provider business mailing address

3651 BRUCKNER BOULEVARD SUITE 6A
BRONX NY
10461-0396
US

V. Phone/Fax

Practice location:
  • Phone: 718-823-9227
  • Fax: 646-779-7018
Mailing address:
  • Phone: 718-823-9227
  • Fax: 646-779-7018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number198164
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number198164
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number198164
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: