Healthcare Provider Details

I. General information

NPI: 1255670139
Provider Name (Legal Business Name): LEWIS SHAPIRO MD.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2013
Last Update Date: 02/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CITY PLACE - 14A
WHITE PLAINS NY
10601-3341
US

IV. Provider business mailing address

10 CITY PLACE - 14A
WHITE PLAINS NY
10601-3341
US

V. Phone/Fax

Practice location:
  • Phone: 914-422-0225
  • Fax: 914-422-0023
Mailing address:
  • Phone: 914-422-0225
  • Fax: 914-422-0023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number074745-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: