Provider Demographics
NPI:1417953779
Name:SCHULMAN, ILENE (ANPC)
Entity Type:Individual
Prefix:
First Name:ILENE
Middle Name:
Last Name:SCHULMAN
Suffix:
Gender:F
Credentials:ANPC
Other - Prefix:
Other - First Name:ILENE
Other - Middle Name:
Other - Last Name:SCHULMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ANPC
Mailing Address - Street 1:1 GUSTAVE LEVY PLACE
Mailing Address - Street 2:BOX 3000
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-241-5520
Mailing Address - Fax:212-348-9233
Practice Address - Street 1:1190 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6503
Practice Address - Country:US
Practice Address - Phone:212-241-5520
Practice Address - Fax:212-348-9233
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF302999363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02213656Medicaid
NY02213656Medicaid
NYP51498Medicare UPIN