1427283050 NPI number — MRS. CARRIE JANINE SHAPIRO-BASEN MS CCC-A

Table of content: MRS. CARRIE JANINE SHAPIRO-BASEN MS CCC-A (NPI 1427283050)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427283050 NPI number — MRS. CARRIE JANINE SHAPIRO-BASEN MS CCC-A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHAPIRO-BASEN
Provider First Name:
CARRIE
Provider Middle Name:
JANINE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS CCC-A
Provider Gender Code:
F

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:
1427283050
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/27/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1944 CORLIES AVE
Provider Second Line Business Mailing Address:
AUDIOLOGY DEPARTMENT-SUITE 102
Provider Business Mailing Address City Name:
NEPTUNE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07753-4862
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-776-4960
Provider Business Mailing Address Fax Number:
732-776-4181

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1944 CORLIES AVE
Provider Second Line Business Practice Location Address:
AUDIOLOGY DEPARTMENT-SUITE 102
Provider Business Practice Location Address City Name:
NEPTUNE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07753-4862
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-776-4960
Provider Business Practice Location Address Fax Number:
732-776-4181
Provider Enumeration Date:
05/27/2009

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: 231H00000X , with the licence number:  41 YA 00054900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 237600000X , with the licence number: MG 00093100 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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