Provider Demographics
NPI:1437329737
Name:SHULMAN, NGINA KESI (LAC, MAC)
Entity Type:Individual
Prefix:MRS
First Name:NGINA
Middle Name:KESI
Last Name:SHULMAN
Suffix:
Gender:F
Credentials:LAC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15302 DIAMOND COVE TER
Mailing Address - Street 2:#10
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4680
Mailing Address - Country:US
Mailing Address - Phone:301-213-9329
Mailing Address - Fax:
Practice Address - Street 1:226 N ADAMS ST
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1891
Practice Address - Country:US
Practice Address - Phone:310-213-9329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDUO1637171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist