MEDICARE: DR. DOV SHMUKLER M.D.

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	207RC0000X	Cardiovascular Disease Physician	225994	NY

General Provider Information

NPI Number	:	1982653812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOV SHMUKLER M.D.

Provider Business Mailing Address
First Line	:	9060 UNION TPKE
Second Line	:	APT. 7E
City	:	GLENDALE
State	:	NY
Zip	:	11385-8003
Country	:	US
Telephone Number	:	917-763-9154
Fax Number	:

Provider Business Practice Location Address
First Line	:	202 FOSTER AVE
Second Line	:	SUITE D
City	:	BROOKLYN
State	:	NY
Zip	:	11230-2119
Country	:	US
Telephone Number	:	718-431-8936
Fax Number	:

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

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	04/01/2021

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