Healthcare Provider Details

I. General information

NPI: 1952300501
Provider Name (Legal Business Name): WALTER B SCHULMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2005
Last Update Date: 07/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 GLEN ST
GLEN COVE NY
11542-2782
US

IV. Provider business mailing address

211 HARBOR HILL RD
EAST HILLS NY
11576-2326
US

V. Phone/Fax

Practice location:
  • Phone: 516-759-0560
  • Fax: 516-676-6008
Mailing address:
  • Phone: 516-625-8634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number092909
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: