Provider Demographics
NPI:1134296866
Name:SCHULMAN, NATHAN D
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:D
Last Name:SCHULMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 EAST SHORE RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023
Mailing Address - Country:US
Mailing Address - Phone:516-487-4500
Mailing Address - Fax:516-829-2796
Practice Address - Street 1:192 EAST SHORE RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023
Practice Address - Country:US
Practice Address - Phone:516-487-4500
Practice Address - Fax:516-829-2796
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY146979207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
600601Medicare ID - Type Unspecified