Provider Demographics
NPI:1720122245
Name:SCHULKIND, MARCUS (LICAC)
Entity Type:Individual
Prefix:MR
First Name:MARCUS
Middle Name:
Last Name:SCHULKIND
Suffix:
Gender:M
Credentials:LICAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1093 BEACON ST
Mailing Address - Street 2:#203
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5695
Mailing Address - Country:US
Mailing Address - Phone:617-734-6667
Mailing Address - Fax:
Practice Address - Street 1:1093 BEACON ST
Practice Address - Street 2:#203
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5695
Practice Address - Country:US
Practice Address - Phone:617-734-6667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA657171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist