Provider Demographics
NPI:1629338843
Name:SHUMANSKI, PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:SHUMANSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:PAUL
Other - Middle Name:
Other - Last Name:SHUMANSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:WALLKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12589-0160
Mailing Address - Country:US
Mailing Address - Phone:845-313-1161
Mailing Address - Fax:
Practice Address - Street 1:1524 ROUTE 208
Practice Address - Street 2:
Practice Address - City:WALLKILL
Practice Address - State:NY
Practice Address - Zip Code:12589-3712
Practice Address - Country:US
Practice Address - Phone:845-313-1161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008314111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor