Provider Demographics
NPI:1679060263
Name:SHULMAN, BRANDIE (SLP)
Entity type:Individual
Prefix:
First Name:BRANDIE
Middle Name:
Last Name:SHULMAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E 40TH ST APT 19K
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2012
Mailing Address - Country:US
Mailing Address - Phone:516-680-5891
Mailing Address - Fax:
Practice Address - Street 1:300 E 40TH ST APT 19K
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2012
Practice Address - Country:US
Practice Address - Phone:516-680-5891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program