Healthcare Provider Details

I. General information

NPI: 1730123670
Provider Name (Legal Business Name): MARCELLE J SHAPIRO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 CENTRAL AVE RADIOLOGY DEPARTMENT
PHILADELPHIA PA
19111-2442
US

IV. Provider business mailing address

1001 BRIGGS RD SUITE 210
MOUNT LAUREL NJ
08054-4100
US

V. Phone/Fax

Practice location:
  • Phone: 215-728-2162
  • Fax: 215-728-4883
Mailing address:
  • Phone: 856-231-4774
  • Fax: 856-231-9699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberMD026482E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberMD026482E
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License NumberMD026482E
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD026482E
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberMD026482E
License Number StatePA
# 6
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberMD026482E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: