Provider Demographics
NPI:1275731333
Name:SHULMAN, BRET JEREMY (LAC LICENSED ACUPUNC)
Entity Type:Individual
Prefix:MR
First Name:BRET
Middle Name:JEREMY
Last Name:SHULMAN
Suffix:
Gender:M
Credentials:LAC LICENSED ACUPUNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 WOODBURY ROAD
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801
Mailing Address - Country:US
Mailing Address - Phone:516-935-9000
Mailing Address - Fax:516-938-5122
Practice Address - Street 1:376 WOODBURY ROAD
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801
Practice Address - Country:US
Practice Address - Phone:516-935-9000
Practice Address - Fax:516-938-5122
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002019171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist