Healthcare Provider Details

I. General information

NPI: 1386620334
Provider Name (Legal Business Name): ARNOLD SHAPIRO OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 06/15/2022
Certification Date: 06/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WALMART VISION CENTER, 631 RT. 9 S.
LITTLE EGG HARBOR CITY NJ
08087
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 609-296-7858
  • Fax:
Mailing address:
  • Phone: 843-860-2644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1235
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: