Provider Demographics
NPI:1528403060
Name:SHMULIK, SHANIT
Entity Type:Individual
Prefix:
First Name:SHANIT
Middle Name:
Last Name:SHMULIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 89TH ST
Mailing Address - Street 2:APT. 1A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-5629
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:344 89TH ST
Practice Address - Street 2:APT. 1A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-5629
Practice Address - Country:US
Practice Address - Phone:917-696-1874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist