Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 212942 | NY |
NPI | 1114949328 |
---|---|
Provider Name | Pavel Shulman |
First Address | New York, NY 10003-5944 |
Second Address | Brooklyn, NY 11235-6875 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 26/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01925759 | (05) | NY |
G86939 | (02) | NY |