Healthcare Provider Details

I. General information

NPI: 1265615686
Provider Name (Legal Business Name): SHAPIRO OPTICAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2007
Last Update Date: 12/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 MALL WALK
YONKERS NY
10704-1201
US

IV. Provider business mailing address

7 MALL WALK
YONKERS NY
10704-1201
US

V. Phone/Fax

Practice location:
  • Phone: 919-968-2626
  • Fax: 914-968-3946
Mailing address:
  • Phone: 919-968-2626
  • Fax: 914-968-3946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name: DR. ALLEN SHAPIRO
Title or Position: OPTOMETRIST
Credential: O.D
Phone: 914-968-2626