=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811154669
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOEL H. SCHECKNER O.D.,
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/20/2008
-----------------------------------------------------
Last Update Date | 05/20/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1983 MARCUS AVE
-----------------------------------------------------
City | NEW HYDE PARK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11042-1016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-326-8822
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1983 MARCUS AVE
-----------------------------------------------------
City | NEW HYDE PARK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11042-1016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-326-8822
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. JOEL HARRIS SCHECKNER
-----------------------------------------------------
Credential | OD
-----------------------------------------------------
Telephone | 516-326-8822
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------