Provider Demographics
NPI:1508829243
Name:SCHEINER, JAC D (MD)
Entity Type:Individual
Prefix:DR
First Name:JAC
Middle Name:D
Last Name:SCHEINER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3211 FRANCIS LEWIS BLVD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-1922
Mailing Address - Country:US
Mailing Address - Phone:718-352-9850
Mailing Address - Fax:718-352-0102
Practice Address - Street 1:5645 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5045
Practice Address - Country:US
Practice Address - Phone:718-670-1594
Practice Address - Fax:718-670-1901
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2273012085B0100X, 2085N0700X, 2085N0904X, 2085R0202X, 2085R0203X, 2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02440586Medicaid
NYF95250Medicare UPIN
NY0258FRMedicare ID - Type Unspecified