Provider Demographics
NPI:1932131844
Name:SCHULMAN, MATTHEW ROSS (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ROSS
Last Name:SCHULMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 E 87TH ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0506
Mailing Address - Country:US
Mailing Address - Phone:212-722-1977
Mailing Address - Fax:212-722-2283
Practice Address - Street 1:21 E 87TH ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-0506
Practice Address - Country:US
Practice Address - Phone:212-722-1977
Practice Address - Fax:212-722-2283
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226530174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY226530OtherLICENSE