MEDICARE: DR. CRAIG ALAN SHAPERO DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0131X	Foot Surgery Podiatrist	25MD00250800	NJ

General Provider Information

NPI Number	:	1043208630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRAIG ALAN SHAPERO DPM

Provider Business Mailing Address
First Line	:	18 CENTRE DR
Second Line	:	SUITE 203
City	:	MONROE TOWNSHIP
State	:	NJ
Zip	:	08831-1501
Country	:	US
Telephone Number	:	609-860-9111
Fax Number	:	609-860-9311

Provider Business Practice Location Address
First Line	:	18 CENTRE DR
Second Line	:	SUITE 203
City	:	MONROE TOWNSHIP
State	:	NJ
Zip	:	08831-1501
Country	:	US
Telephone Number	:	609-860-9111
Fax Number	:	609-860-9311

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2005
Last Update Date	:	03/27/2014

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