Healthcare Provider Details

I. General information

NPI: 1740381516
Provider Name (Legal Business Name): MICHAEL SHAPIRO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2148 OCEAN AVE FL 5
BROOKLYN NY
11229-1484
US

IV. Provider business mailing address

2148 OCEAN AVE FL 5
BROOKLYN NY
11229-1484
US

V. Phone/Fax

Practice location:
  • Phone: 123-981-2882
  • Fax: 718-332-3454
Mailing address:
  • Phone: 212-398-1288
  • Fax: 718-332-3454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number234760
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: