Provider Demographics
NPI:1750454831
Name:SCHONFELD, SCOTT M (DPM)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:M
Last Name:SCHONFELD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 MERRICK AVE
Mailing Address - Street 2:STE 120
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-3406
Mailing Address - Country:US
Mailing Address - Phone:516-705-8020
Mailing Address - Fax:516-705-8822
Practice Address - Street 1:31 MERRICK AVE STE 120
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566
Practice Address - Country:US
Practice Address - Phone:516-705-8020
Practice Address - Fax:516-705-8822
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005976213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02732570Medicaid
NYPJ2471Medicare ID - Type Unspecified
NY02732570Medicaid