Provider Demographics
NPI:1285879932
Name:SHULMAN, DENNIS GARY (PHD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:GARY
Last Name:SHULMAN
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 1:285 HARDENBURGH AVE
Mailing Address - Street 2:
Mailing Address - City:DEMAREST
Mailing Address - State:NJ
Mailing Address - Zip Code:07627-1306
Mailing Address - Country:US
Mailing Address - Phone:201-784-0880
Mailing Address - Fax:
Practice Address - Street 1:285 HARDENBURGH AVE
Practice Address - Street 2:
Practice Address - City:DEMAREST
Practice Address - State:NJ
Practice Address - Zip Code:07627-1306
Practice Address - Country:US
Practice Address - Phone:201-784-0880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-10
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJS-101699103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist