Individual provider Active NPI

Alan Shulik, PH.D.

  • Clinical Psychologist
  • New Haven, CT
National Provider Identifier
1477668010
Registry record updated Jun 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
864 Issued in CT
Practice address
147 Bishop St
New Haven, CT 06511-3717
Phone
(203) 915-3988
Fax
(203) 533-5056
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 864 CT Primary

Addresses

Primary practice location

147 Bishop St
New Haven, CT 06511-3717

Mailing address

147 Bishop St
New Haven, CT 06511-3717
Phone (203) 915-3988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
864CTMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia M Shiller, PH.D., LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245801600000",
    "number": "1477668010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 BISHOP ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113717",
            "telephone_number": "203-915-3988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 BISHOP ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113717",
            "telephone_number": "203-915-3988",
            "fax_number": "203-533-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULIK",
        "first_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2009-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.