Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | NJ6J652 | NJ |
N | 208800000X | Urologist | NY18753 | NY |
NPI | 1023037058 |
---|---|
Provider Name | Elliot Shulman |
First Address | Jersey City, NJ 07304 |
Second Address | Jersey City, NJ 07304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7312008 | (05) | NJ |
G53785 | (02) |