Healthcare Provider Details

I. General information

NPI: 1669496378
Provider Name (Legal Business Name): HARRY I SHUMAN M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4422 3RD AVE
BRONX NY
10457-2545
US

IV. Provider business mailing address

79 MYSTIC DR
OSSINING NY
10562-1965
US

V. Phone/Fax

Practice location:
  • Phone: 718-960-9122
  • Fax: 718-960-3147
Mailing address:
  • Phone: 914-762-3321
  • Fax: 914-762-3352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number210207
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: