MEDICARE: DEVORAH SHULMAN MS

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	174H00000X	Health Educator

General Provider Information

NPI Number	:	1386033777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEVORAH SHULMAN MS

Provider Business Mailing Address
First Line	:	34 GEDNEY WAY
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-2519
Country	:	US
Telephone Number	:	347-667-9776
Fax Number	:

Provider Business Practice Location Address
First Line	:	34 GEDNEY WAY
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-2519
Country	:	US
Telephone Number	:	347-667-9776
Fax Number	:

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

Provider Enumeration Date	:	01/22/2015
Last Update Date	:	01/22/2015

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