Provider Demographics
NPI:1447559505
Name:SHULIK, OLEG (MD)
Entity type:Individual
Prefix:DR
First Name:OLEG
Middle Name:
Last Name:SHULIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 419430
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-9430
Mailing Address - Country:US
Mailing Address - Phone:201-967-8221
Mailing Address - Fax:201-483-2242
Practice Address - Street 1:799 BLOOMFIELD AVE STE 102
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-1301
Practice Address - Country:US
Practice Address - Phone:973-239-8373
Practice Address - Fax:973-239-8403
Is Sole Proprietor?:No
Enumeration Date:2011-03-15
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09202400207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology