1194739243 NPI number — DR. JEFFREY T SHAPIRO MD

Table of content: DR. JEFFREY T SHAPIRO MD (NPI 1194739243)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194739243 NPI number — DR. JEFFREY T SHAPIRO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHAPIRO
Provider First Name:
JEFFREY
Provider Middle Name:
T
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194739243
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/11/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4 WESTCHESTER PARK DRIVE
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
WHITE PLAINS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10604-3431
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-472-1900
Provider Business Mailing Address Fax Number:
914-472-8454

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 WESTCHESTER PARK DRIVE
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
WHITE PLAINS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10604-3431
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-472-1900
Provider Business Practice Location Address Fax Number:
914-472-8454
Provider Enumeration Date:
07/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  186468 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 110138386 . This is a "RAILROAD MCR" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133783251 . This is a "BEECHSTREET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133783251 . This is a "CHN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133783251 . This is a "MAGNACARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3C2657 . This is a "HEALTHNET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 42881 . This is a "GHI HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3686289 . This is a "AETNA HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 6012990 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P416373 . This is a "OXFORD & OXFORD MCR" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 002652 . This is a "CONNECTICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133783251 . This is a "ANTHEM" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 160855P . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133783251 . This is a "HORIZON HEALTHCARE OF NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133783251 . This is a "1199" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133783251 . This is a "MULTIPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: O1588334 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4630351-001 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5502760 . This is a "AETNA PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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