Provider Demographics
NPI:1477668010
Name:SHULIK, ALAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:SHULIK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 BISHOP ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-3717
Mailing Address - Country:US
Mailing Address - Phone:203-915-3988
Mailing Address - Fax:
Practice Address - Street 1:147 BISHOP ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3717
Practice Address - Country:US
Practice Address - Phone:203-915-3988
Practice Address - Fax:203-533-5056
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT864103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical