MEDICARE: DR. LEONID SHKOLNIK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	188720	NY

General Provider Information

NPI Number	:	1184624736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEONID SHKOLNIK

Provider Business Mailing Address
First Line	:	1250 57TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-4537
Country	:	US
Telephone Number	:	718-283-5700
Fax Number	:	718-283-5730

Provider Business Practice Location Address
First Line	:	1250 57TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-4537
Country	:	US
Telephone Number	:	718-283-5700
Fax Number	:	718-283-5730

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	10/23/2014

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