Provider Demographics
NPI:1104092469
Name:SCHEINER, JIM
Entity type:Individual
Prefix:
First Name:JIM
Middle Name:
Last Name:SCHEINER
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:JIM
Other - Middle Name:
Other - Last Name:SCHEINER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:3766 ILLONA LN
Mailing Address - Street 2:3766 ILLONA LN
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572
Mailing Address - Country:US
Mailing Address - Phone:516-764-3775
Mailing Address - Fax:
Practice Address - Street 1:3766 ILLONA LN
Practice Address - Street 2:3766 ILLONA LN.
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-5973
Practice Address - Country:US
Practice Address - Phone:516-764-3775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0296701835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist