Provider Demographics
NPI:1861431090
Name:SCHULMAN, LEE G (MD)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:G
Last Name:SCHULMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 MIDDLE NECK RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-1126
Mailing Address - Country:US
Mailing Address - Phone:516-482-4477
Mailing Address - Fax:516-482-7437
Practice Address - Street 1:212 MIDDLE NECK RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-1126
Practice Address - Country:US
Practice Address - Phone:516-482-4477
Practice Address - Fax:516-482-7437
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY180444208D00000X, 202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Not Answered202K00000XAllopathic & Osteopathic PhysiciansPhlebology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE17765Medicare UPIN
NY31F181Medicare ID - Type Unspecified