Healthcare Provider Details

I. General information

NPI: 1861909038
Provider Name (Legal Business Name): NICHOLAS SCHULMAN PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2018
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

496 KINGS HWY N STE 110
CHERRY HILL NJ
08034-1015
US

IV. Provider business mailing address

175 ROUTE 70 STE 19
MEDFORD NJ
08055-2355
US

V. Phone/Fax

Practice location:
  • Phone: 856-438-5633
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA02171300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number25MT00227000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: