Individual provider Active NPI

Tamara Shulman, PHD

  • Psychologist
  • Clifton, NJ
National Provider Identifier
1790707560
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35S100133200 Issued in NJ
Practice address
925 Clifton Avenue
Suite #103
Clifton, NJ 07013
Phone
(973) 471-9506
Fax
(212) 980-0578
NPI assigned
Jul 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35S100133200 NJ Primary
Psychologist 103T00000X 0064441 NY

Addresses

Primary practice location

925 Clifton Avenue
Suite #103
Clifton, NJ 07013

Mailing address

925 Clifton Avenue
Suite #103
Clifton, NJ 07013
Phone (973) 471-9506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041005000253 NJ Practitioner - Clinical Psychologist 0042279283 Practice locations: Clifton, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

925 Clifton Ave
Suite 103
Clifton, NJ 07013-2724
Phone (973) 471-9506

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
35S100133200NJMDPsychologist
0064441NYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790707560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 CLIFTON AVENUE",
            "address_2": "SUITE #103",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "07013",
            "telephone_number": "973-471-9506",
            "fax_number": "212-980-0578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 CLIFTON AVENUE",
            "address_2": "SUITE #103",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "07013",
            "telephone_number": "973-471-9506",
            "fax_number": "212-980-0578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULMAN",
        "first_name": "TAMARA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35S100133200",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "0064441",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.