MEDICARE: ABRAHAM SHULMAN, M. D., F..A. C. S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker	0815661	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	09407G	OTHER	NY	GHI MEDICARE
2	09407	OTHER	NY	GHI MEDICARE INDIVID
3	169961	OTHER	NY	BCBS MEDICARE

General Provider Information

NPI Number	:	1174702823
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABRAHAM SHULMAN, M. D., F..A. C. S

Provider Business Mailing Address
First Line	:	11835 QUEENS BLVD
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-7200
Country	:	US
Telephone Number	:	718-773-8888
Fax Number	:	718-465-3669

Provider Business Practice Location Address
First Line	:	11835 QUEENS BLVD
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-7200
Country	:	US
Telephone Number	:	718-773-8888
Fax Number	:	718-465-3669

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	ABRAHAM SHULMAN
Credential	:	M.D
Telephone Number	:	718-773-8888

Provider Enumeration Date	:	10/30/2007
Last Update Date	:	10/30/2007

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