Provider Demographics
NPI:1386908838
Name:SHULMAN, JUDY (MED)
Entity type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:
Last Name:SHULMAN
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8663 PINTO ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-1245
Mailing Address - Country:US
Mailing Address - Phone:718-465-5106
Mailing Address - Fax:
Practice Address - Street 1:8663 PINTO ST
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-1245
Practice Address - Country:US
Practice Address - Phone:718-465-5106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-29
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist