Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | N0058591 | NY |
Y | 222Z00000X | Podiatrist | N0058591 | NY |
NPI | 1053429142 |
---|---|
Provider Name | Dr. Marcus Nathan Shapiro |
First Address | Fresh Meadows, NY 11366-1960 |
Second Address | North Bellmore, NY 11710-1833 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2006 |
Last Update Date | 24/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U71895 | (02) | NY |