Healthcare Provider Details

I. General information

NPI: 1306961081
Provider Name (Legal Business Name): DR. ARNOLD SHAPIRO PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 01/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15N VIENNA AVE
EGG HARBOR CITY NJ
08215-3246
US

IV. Provider business mailing address

15 N VIENNA AVE
EGG HARBOR CITY NJ
08215-3246
US

V. Phone/Fax

Practice location:
  • Phone: 843-860-2644
  • Fax:
Mailing address:
  • Phone: 843-860-2644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number27OA00304000
License Number StateNJ

VIII. Authorized Official

Name: DR. ARNOLD SHAPIRO
Title or Position: PRESIDENT
Credential: PA
Phone: 843-860-2644