Provider Demographics
NPI:1972712693
Name:WINEFSKY, SHELDON (OPTICIAN)
Entity Type:Individual
Prefix:
First Name:SHELDON
Middle Name:
Last Name:WINEFSKY
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 HUNTINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-3711
Mailing Address - Country:US
Mailing Address - Phone:516-887-3250
Mailing Address - Fax:
Practice Address - Street 1:3 HUNTINGTON AVE
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-3711
Practice Address - Country:US
Practice Address - Phone:516-887-3250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3193156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1318270001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER