Provider Demographics
NPI:1790820462
Name:SCHOLNICK, BARRY (OD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:
Last Name:SCHOLNICK
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 1:704 WENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-4943
Mailing Address - Country:US
Mailing Address - Phone:516-485-2913
Mailing Address - Fax:
Practice Address - Street 1:1445 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-2404
Practice Address - Country:US
Practice Address - Phone:516-616-1771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV004558152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00916418Medicaid
NYU54360Medicare UPIN