Marc Shuldiner, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

022602 Issued in NY

Practice address

519 8TH Ave FL 9
New York, NY 10018-6506

Phone

(212) 683-3339

NPI assigned

Nov 21, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 30, 2020 through Oct 30, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1912476763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 8TH AVE FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100186506",
            "telephone_number": "212-683-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 8TH AVE FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100186506",
            "telephone_number": "212-683-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULDINER",
        "first_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-21",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "022602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toesha Manishkumar Shukla, PHYSICAL THERAPIST
• Brett Shukri, PA-C
• Scott Shukri, PA
• Max Shulaker, MD
• Sarah Shulbank-Smith, MA, MT-BC
• Tally Shuldiner
• Lashanda Shuler Hawkins, LMSW
• Elizabeth May Shull, LCSW
• Kara Shull, D.P.T
• Mariel Therese Shull, PHARMD

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.