Provider Demographics
NPI:1326274945
Name:SCHULMAN, MITCHELL (PHD)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:
Last Name:SCHULMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:MITCHELL
Other - Middle Name:
Other - Last Name:SCHULMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:201 BRIARWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:NY
Mailing Address - Zip Code:10589-1810
Mailing Address - Country:US
Mailing Address - Phone:914-669-5811
Mailing Address - Fax:914-669-5811
Practice Address - Street 1:201 BRIARWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:SOMERS
Practice Address - State:NY
Practice Address - Zip Code:10589-1810
Practice Address - Country:US
Practice Address - Phone:914-669-5811
Practice Address - Fax:914-669-5811
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015369103T00000X
NY018578225700000X
CT004346225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist