Provider Demographics
NPI:1275680498
Name:SHULMAN, JEFFREY S (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:S
Last Name:SHULMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 OLD SHORT HILLS RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-5604
Mailing Address - Country:US
Mailing Address - Phone:973-994-1992
Mailing Address - Fax:973-994-1995
Practice Address - Street 1:22 OLD SHORT HILLS RD
Practice Address - Street 2:SUITE 109
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5604
Practice Address - Country:US
Practice Address - Phone:973-994-1992
Practice Address - Fax:973-994-1995
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00473800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7322909Medicaid
NJSH903556Medicare ID - Type Unspecified
NJU65890Medicare UPIN