Provider Demographics
NPI:1780850149
Name:SCHULMAN, KENNETH MICHAEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:MICHAEL
Last Name:SCHULMAN
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 1:101 CEDAR LN
Mailing Address - Street 2:SUITE 303
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4417
Mailing Address - Country:US
Mailing Address - Phone:201-692-1036
Mailing Address - Fax:201-353-2555
Practice Address - Street 1:101 CEDAR LN
Practice Address - Street 2:SUITE 303
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4417
Practice Address - Country:US
Practice Address - Phone:201-692-1036
Practice Address - Fax:201-353-2555
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI1242103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical