Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 186818 | NY |
NPI | 1104827716 |
---|---|
Provider Name | Richard Shapiro |
First Address | New York, NY 10016-4750 |
Second Address | New York, NY 10016-4750 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2005 |
Last Update Date | 21/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F73841 | (02) | NY |