Healthcare Provider Details

I. General information

NPI: 1104092469
Provider Name (Legal Business Name): JIM SCHEINER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JIM SCHEINER RPH

II. Dates (important events)

Enumeration Date: 05/06/2008
Last Update Date: 03/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3766 ILLONA LN 3766 ILLONA LN.
OCEANSIDE NY
11572-5973
US

IV. Provider business mailing address

3766 ILLONA LN 3766 ILLONA LN
OCEANSIDE NY
11572
US

V. Phone/Fax

Practice location:
  • Phone: 516-764-3775
  • Fax:
Mailing address:
  • Phone: 516-764-3775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number029670
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number029670
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: