Provider Demographics
NPI:1316914468
Name:SCHOENBART, STEVEN M (OD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:M
Last Name:SCHOENBART
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 STEWART AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4893
Mailing Address - Country:US
Mailing Address - Phone:516-794-0704
Mailing Address - Fax:516-794-7562
Practice Address - Street 1:901 STEWART AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4893
Practice Address - Country:US
Practice Address - Phone:516-794-0704
Practice Address - Fax:516-794-7562
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT004712152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400005494OtherPTAN
NYC32791OtherMEDICARE ID
NY0334170001Medicare NSC
NYC32791OtherMEDICARE ID