Provider Demographics
NPI:1174702823
Name:ABRAHAM SHULMAN, M. D., F..A. C. S
Entity type:Organization
Organization Name:ABRAHAM SHULMAN, M. D., F..A. C. S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SHULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-773-8888
Mailing Address - Street 1:11835 QUEENS BLVD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-7200
Mailing Address - Country:US
Mailing Address - Phone:718-773-8888
Mailing Address - Fax:718-465-3669
Practice Address - Street 1:11835 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-7200
Practice Address - Country:US
Practice Address - Phone:718-773-8888
Practice Address - Fax:718-465-3669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0815661172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY09407GOtherGHI MEDICARE
NY09407OtherGHI MEDICARE INDIVID
NY169961OtherBCBS MEDICARE
NY09407OtherGHI MEDICARE INDIVID