MEDICARE: FLORENCE SHUM D.O.

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	2084N0600X	Clinical Neurophysiology Physician	254138	NY
2	2084N0400X	Neurology Physician	254138	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	83-4150954	OTHER	NY	IRS

General Provider Information

NPI Number	:	1336378850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FLORENCE SHUM D.O.

Provider Business Mailing Address
First Line	:	8321 20TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-3195
Country	:	US
Telephone Number	:	718-996-9888
Fax Number	:	718-996-2888

Provider Business Practice Location Address
First Line	:	8321 20TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-3001
Country	:	US
Telephone Number	:	718-996-9888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2009
Last Update Date	:	02/12/2026

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