MEDICARE: E SHAPIRO DPM PC

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	261QP1100X	Podiatric Clinic/Center	004180	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6633640001	OTHER	NY	DME PTAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497054704
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	E SHAPIRO DPM PC

Provider Business Mailing Address
First Line	:	301 OCEAN VIEW AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-6826
Country	:	US
Telephone Number	:	718-332-2582
Fax Number	:	718-743-3963

Provider Business Practice Location Address
First Line	:	301 OCEAN VIEW AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-6826
Country	:	US
Telephone Number	:	718-332-2582
Fax Number	:	718-743-3963

Authorized Official
Title or Position	:	PODIATRIST
Name	:	DR. EUGENE SHAPIRO
Credential	:	DPM
Telephone Number	:	718-332-2582

Provider Enumeration Date	:	03/25/2011
Last Update Date	:	06/23/2014

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