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General NPI Number Information
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NPI Number | 1760500847
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Entity Type | Organization
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Legal Business Name | GIDEON L SCHNECK MD PC
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2500 NESCONSET HWY 17B
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City | STONY BROOK
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State | NY
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Zip | 11790
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Country | US
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Telephone | 631-246-9140
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Fax | 631-246-9244
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Provider Business Mailing Address
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Address Line | 2500 NESCONSET HWY 17B
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City | STONY BROOK
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State | NY
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Zip | 11790
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Country | US
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Telephone | 631-246-9140
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Fax | 631-246-9244
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. GIDEON LLOYD SCHNECK
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Credential | MD
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Telephone | 631-246-9140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 185627
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License Number State | NY
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