Provider Demographics
NPI:1548471873
Name:SCHULMAN, GLENN DAVID (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GLENN
Middle Name:DAVID
Last Name:SCHULMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 STEVENSON RD
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-2435
Mailing Address - Country:US
Mailing Address - Phone:203-562-2824
Mailing Address - Fax:
Practice Address - Street 1:322 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3136
Practice Address - Country:US
Practice Address - Phone:203-481-1104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9407183500000X
NJ28RI02624700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist