Provider Demographics
NPI:1407134224
Name:SHUM, MILI
Entity Type:Individual
Prefix:
First Name:MILI
Middle Name:
Last Name:SHUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 SUNSHINE COTTAGE RD
Mailing Address - Street 2:SKYLINE SUITE 1N-C26
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1524
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:222 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:WEST HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10604-2906
Practice Address - Country:US
Practice Address - Phone:914-493-7585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11415615-1205207R00000X, 207RA0201X, 207N00000X
CT54852207R00000X, 208M00000X
NY264486208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist