Active NPI
Marc J Shulman, PSY.D.
- Psychologist
- West Haven, CT
National Provider Identifier
1689783607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 015629
- Practice address
- 950 Campbell Ave
West Haven, CT 06516-2770 - Phone
- (203) 932-5711
- Fax
- (203) 937-4951
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 002514 | CT | |
| Psychologist | 103T00000X | 015629 | NY | Primary |
Addresses
Primary practice location
950 Campbell Ave
West Haven, CT 06516-2770
Mailing address
950 Campbell Ave
West Haven, CT 06516-2770
Phone (203) 932-5711
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002514 | CT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242691200000",
"number": "1689783607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 CAMPBELL AVE",
"city": "WEST HAVEN",
"state": "CT",
"postal_code": "065162770",
"telephone_number": "203-932-5711",
"fax_number": "203-937-4951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 CAMPBELL AVE",
"city": "WEST HAVEN",
"state": "CT",
"postal_code": "065162770",
"telephone_number": "203-932-5711",
"fax_number": "203-937-4951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHULMAN",
"first_name": "MARC",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2009-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CT",
"license": "002514",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "015629",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Haven, CT
- Shoreline Family Chiropractic & Wellness
- Shoreline Social Learning
- Shoreline Wellness Behavioral Health Clinic, LLC
- Shoreline Wellness Behavioral Health Outreach Inc
- Shoreline Wellness Center, LLC.
- Marianne E Silva, LCSW
- Scott Wolfe Silver, RPH
- Jamie Silverberg, PSYD
- Silvers Drug Shop Inc.
- Elissa Nancy Silvio, NP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.