1063496537 NPI number — DR. WARREN B SHAPIRO MD

Table of content: DR. WARREN B SHAPIRO MD (NPI 1063496537)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063496537 NPI number — DR. WARREN B SHAPIRO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHAPIRO
Provider First Name:
WARREN
Provider Middle Name:
B
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:
1063496537
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/11/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 BROOKDALE PLZ
Provider Second Line Business Mailing Address:
ROOM 169CHC
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11212-3139
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-240-5615
Provider Business Mailing Address Fax Number:
718-485-4064

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 BROOKDALE PLZ
Provider Second Line Business Practice Location Address:
ROOM 169CHC
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11212-3139
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-240-5615
Provider Business Practice Location Address Fax Number:
718-485-4064
Provider Enumeration Date:
11/30/2005

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: 207RN0300X , with the licence number:  100379 , 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: 2349200 . This is a "AETNA US HEALTHCARE - HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2503982 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 56942 . This is a "BLUECHOICE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5826241 . This is a "AETNA US HEALTHCARE -PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 218693 . This is a "WORKMAN'S COMP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2506274 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 569421 . This is a "MEDICARE PTAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 6014071009 . This is a "CIGNA - SENIORS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: KS445 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00172129 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100379 . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: BK0200401 . This is a "AMERICHOICE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 08S761 . This is a "EMPIRE BC/BS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P2085088 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 100379-B41 . This is a "1199 NBF" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 14-43662 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 100379-A41 . This is a "1199 NBF" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 6014071006 . This is a "CIGNA - REGULAR" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 11364 . This is a "ELDERPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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