Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | N004141-1 | NY |
Y | 222Z00000X | Podiatrist | N004141-1 | NY |
N | 213EP1101X | Primary Podiatric Medicine | N004141-1 | NY |
N | 213ES0131X | Foot Surgery | N004141-1 | NY |
NPI | 1215019161 |
---|---|
Provider Name | Dr. Andrew Shapiro |
First Address | Valley Stream, NY 11580-5707 |
Second Address | Valley Stream, NY 11580-5707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 10/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P1W201 | MEDICARE ID-TYPE UNSPECIFIED (01) | NY |
T51390 | (02) | NY |