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General NPI Number Information
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NPI Number | 1215556469
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Entity Type | Individual
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Provider Name | GABRIEL SHAKAROV MD
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Gender | Male
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Dates
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Enumeration Date | 04/08/2020
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 2046 W MAIN ST STE 2
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City | STAMFORD
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State | CT
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Zip | 06902-4523
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Country | US
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Telephone | 203-869-3082
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Fax |
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Provider Business Mailing Address
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Address Line | 8210 217TH ST
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City | QUEENS VILLAGE
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State | NY
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Zip | 11427-1414
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 80656
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License Number State | CT
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