Provider Demographics
NPI:1598951345
Name:BRUCE S. SHULMAN MD PC
Entity Type:Organization
Organization Name:BRUCE S. SHULMAN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-365-1600
Mailing Address - Street 1:444 COMMUNITY DR
Mailing Address - Street 2:LOWER LEVEL STE. 3
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3820
Mailing Address - Country:US
Mailing Address - Phone:516-365-1600
Mailing Address - Fax:516-365-2181
Practice Address - Street 1:444 COMMUNITY DR
Practice Address - Street 2:LOWER LEVEL STE. 3
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3820
Practice Address - Country:US
Practice Address - Phone:516-365-1600
Practice Address - Fax:516-365-2181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY135234207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty