MEDICARE: DR. JONATHAN M. SCHONFELD, INC.

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	152W00000X	Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356428874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. JONATHAN M. SCHONFELD, INC.

Provider Business Mailing Address
First Line	:	6801 PEARL RD
Second Line	:
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-3616
Country	:	US
Telephone Number	:	440-845-3006
Fax Number	:	440-884-5951

Provider Business Practice Location Address
First Line	:	6801 PEARL RD
Second Line	:
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-3616
Country	:	US
Telephone Number	:	440-845-3006
Fax Number	:	440-884-5951

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JONATHAN MARK SCHONFELD
Credential	:	O. D.
Telephone Number	:	440-845-3006

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	10/29/2012

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