Healthcare Provider Details

I. General information

NPI: 1720053911
Provider Name (Legal Business Name): RON SHAPIRO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 02/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 EAST 98TH STREET 12TH FLOOR
NEW YORK NY
10029-6574
US

IV. Provider business mailing address

ONE GUSTAVE L LEVY PLACE BOX 1104
NEW YORK NY
10029-6574
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-8035
  • Fax:
Mailing address:
  • Phone: 212-241-8035
  • Fax: 212-241-2064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number147322
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: