Healthcare Provider Details

I. General information

NPI: 1922090414
Provider Name (Legal Business Name): ROBERT SHAPIRO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 3690
APO AE
09126
DE

IV. Provider business mailing address

UNIT 3690
APO AE
09126
DE

V. Phone/Fax

Practice location:
  • Phone: 4-965-6561
  • Fax: 8263
Mailing address:
  • Phone: 4-965-6561
  • Fax: 8263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9760
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: