Basic Information
Provider Information
NPI: 1790357226
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHULMAN
FirstName: PATRICIA
MiddleName: F
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 560 SYLVAN AVE STE 1110
Address2:  
City: ENGLEWOOD CLIFFS
State: NJ
PostalCode: 076323118
CountryCode: US
TelephoneNumber: 6788941116
FaxNumber:  
Practice Location
Address1: 90 CANAL ST STE 400
Address2:  
City: BOSTON
State: MA
PostalCode: 021142022
CountryCode: US
TelephoneNumber: 6155709959
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/14/2021
LastUpdateDate: 07/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103K00000X  Y Behavioral Health & Social Service ProvidersBehavioral Analyst 

No ID Information.


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