Healthcare Provider Details

I. General information

NPI: 1013023977
Provider Name (Legal Business Name): MS. JUDY SHAPIRO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 FLANDERS LN
WEST HURLEY NY
12491-5612
US

IV. Provider business mailing address

39 FLANDERS LN
WEST HURLEY NY
12491-5612
US

V. Phone/Fax

Practice location:
  • Phone: 845-594-6098
  • Fax:
Mailing address:
  • Phone: 845-679-8922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number010582
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: