Provider Demographics
NPI:1457444242
Name:SHULMAN UROLOGY PA
Entity Type:Organization
Organization Name:SHULMAN UROLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:YALE
Authorized Official - Middle Name:C
Authorized Official - Last Name:SHULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-433-1057
Mailing Address - Street 1:2255 JOHN F KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-1428
Mailing Address - Country:US
Mailing Address - Phone:201-433-1057
Mailing Address - Fax:201-435-2716
Practice Address - Street 1:2255 JOHN F KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-1428
Practice Address - Country:US
Practice Address - Phone:201-433-1057
Practice Address - Fax:201-435-2716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA33466174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7311907Medicaid
NJ7311907Medicaid