1831124858 NPI number — DR. TIFFANY B SHAPIRO DO

Table of content: DR. TIFFANY B SHAPIRO DO (NPI 1831124858)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831124858 NPI number — DR. TIFFANY B SHAPIRO DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHAPIRO
Provider First Name:
TIFFANY
Provider Middle Name:
B
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HARADA
Provider Other First Name:
TIFFANY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1831124858
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/06/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 HYGEIA DR
Provider Second Line Business Mailing Address:
SUITE 2300
Provider Business Mailing Address City Name:
NEWARK
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19713-2049
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 FOULK RD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19803-3155
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-655-8868
Provider Business Practice Location Address Fax Number:
302-655-3744
Provider Enumeration Date:
07/11/2006

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: 207Q00000X , with the licence number:  OS012584 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: C2-0011393 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2116020 . This is a "MAMSI-YH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50018554 . This is a "CAPITAL BLUE CROSS-YH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 620767 . This is a "CAREFIRST MD BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 001950140 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1500059 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 100483 . This is a "GEISINGER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 5917601 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P005986 . This is a "GATEWAY-YH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 105522 . This is a "JOHNS HOPKINS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 143541 . This is a "UNISON-YH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 20024912 . This is a "AMERIHEALTH MERCY-YH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com