Provider Demographics
NPI:1134390644
Name:SHANDOR ZELENGER, O.D., P.C.
Entity type:Organization
Organization Name:SHANDOR ZELENGER, O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANDOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZELENGER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:917-586-9092
Mailing Address - Street 1:225 BROADWAY
Mailing Address - Street 2:SUITE 1015
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-3001
Mailing Address - Country:US
Mailing Address - Phone:718-265-0201
Mailing Address - Fax:212-748-1285
Practice Address - Street 1:225 BROADWAY
Practice Address - Street 2:SUITE 1015
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-3001
Practice Address - Country:US
Practice Address - Phone:718-265-0201
Practice Address - Fax:212-748-1285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006017152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02010548Medicaid
NY1315940001Medicare NSC
NY02010548Medicaid
NYW25881Medicare PIN
NYU77821Medicare UPIN
NYC60641Medicare PIN