Healthcare Provider Details

I. General information

NPI: 1477769966
Provider Name (Legal Business Name): LYUDMILA S SHULMAN MS, CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HACKENSACK UNIVERSITY MEDICAL CENTER 30 PROSPECT AVE
HACKENSACK NJ
07601
US

IV. Provider business mailing address

HACKENSACK UNIVERSITY MEDICAL CENTER 30 PROSPECT AVE
HACKENSACK NJ
07601
US

V. Phone/Fax

Practice location:
  • Phone: 201-996-5227
  • Fax: 201-996-5176
Mailing address:
  • Phone: 201-996-5227
  • Fax: 201-996-5176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: