Provider Demographics
NPI:1477599348
Name:SHULMAN, LEON H (MD)
Entity Type:Individual
Prefix:DR
First Name:LEON
Middle Name:H
Last Name:SHULMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 UNION AVE STE 2B
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-3064
Mailing Address - Country:US
Mailing Address - Phone:908-231-1311
Mailing Address - Fax:908-231-1324
Practice Address - Street 1:245 UNION AVE STE 2B
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-3064
Practice Address - Country:US
Practice Address - Phone:908-231-1311
Practice Address - Fax:908-231-1324
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05607900207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4586701Medicaid
NJSH89438Medicare PIN
NJ4586701Medicaid