Provider Demographics
NPI:1447254941
Name:LELONEK, DAVID (OD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:LELONEK
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 1:486 SPRUCE LN
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-3704
Mailing Address - Country:US
Mailing Address - Phone:516-485-3637
Mailing Address - Fax:516-485-0370
Practice Address - Street 1:928 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-2109
Practice Address - Country:US
Practice Address - Phone:516-520-6580
Practice Address - Fax:516-520-6584
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT004678-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00975966Medicaid
U35956Medicare UPIN
NY00975966Medicaid