Provider Demographics
NPI:1265457311
Name:SHIFFMAN, MICHAEL IAN (ATC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:IAN
Last Name:SHIFFMAN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 IROQUOIS TRL
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-5451
Mailing Address - Country:US
Mailing Address - Phone:908-575-4031
Mailing Address - Fax:
Practice Address - Street 1:13 IROQUOIS TRL
Practice Address - Street 2:
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876-5451
Practice Address - Country:US
Practice Address - Phone:908-575-4031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ002894072255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer