Matisyahu Y Shulman, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

25MA10066700 Issued in NJ

Practice address

815 Elm Ave
Teaneck, NJ 07666

Phone

(646) 653-2019

NPI assigned

Apr 25, 2012

Last updated

Nov 5, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1750649992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 ELM AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076662523",
            "telephone_number": "646-653-2019",
            "fax_number": "201-371-5149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 ELM AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "07666",
            "telephone_number": "646-653-2019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1051 Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10032",
            "country_code": "US",
            "telephone_number": "646-774-6315",
            "fax_number": "646-774-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHULMAN",
        "first_name": "MATISYAHU",
        "middle_name": "Y",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-25",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "60 273414",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA10066700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Corey Shipley, LPC
• Aspan Meherzad Shokrekhuda, M.D.
• Sara F Shoshana
• Daniel Shtern, DDS
• Jared Dov Shulman, D.M.D.
• Rena Rebecca Shulman, PT
• Michael D Sicklick, DMD
• Atara Siegel
• Robin Siegel
• Elissa Siev, OTR/L

• Psychiatry Physician in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; 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.