Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207NS0135X | Procedural Dermatology | 002888 | NY |
NPI | 1205025988 |
---|---|
Provider Name | Dr. Jerry Shapiro |
First Address | New York, NY 10016-6402 |
Second Address | New York, NY 10016-6402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2007 |
Last Update Date | 18/10/2007 |