Provider Demographics
NPI:1518068022
Name:SHULMAN, BRUCE STUART (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:STUART
Last Name:SHULMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:444 COMMUNITY DRIVE
Mailing Address - Street 2:LOWER LEVEL STE. 3
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030
Mailing Address - Country:US
Mailing Address - Phone:516-365-1600
Mailing Address - Fax:516-365-2181
Practice Address - Street 1:444 COMMUNITY DRIVE
Practice Address - Street 2:LOWER LEVEL STE. 3
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030
Practice Address - Country:US
Practice Address - Phone:516-365-1600
Practice Address - Fax:516-365-2181
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY135234207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY58G78OtherEMPIRE BLUE CROSS/BLUE SH
NYAP450OtherOXFORD HEALTHPLAN
NY58G78OtherEMPIRE BLUE CROSS/BLUE SH
NYB17021Medicare UPIN