MEDICARE: DR. PAUL SHUMANSKI DC

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	111N00000X	Chiropractor	008314	NY

General Provider Information

NPI Number	:	1629338843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL SHUMANSKI DC

Provider Business Mailing Address
First Line	:	PO BOX 160
Second Line	:
City	:	WALLKILL
State	:	NY
Zip	:	12589-0160
Country	:	US
Telephone Number	:	845-313-1161
Fax Number	:

Provider Business Practice Location Address
First Line	:	1524 ROUTE 208
Second Line	:
City	:	WALLKILL
State	:	NY
Zip	:	12589-3712
Country	:	US
Telephone Number	:	845-313-1161
Fax Number	:

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

Provider Enumeration Date	:	05/22/2012
Last Update Date	:	05/22/2012

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