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General NPI Number Information
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NPI Number | 1548544604
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Entity Type | Organization
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Legal Business Name | PMR MEDICAL PC
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Dates
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Enumeration Date | 10/06/2011
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 1 N WASHINGTON AVE
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City | BERGENFIELD
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State | NJ
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Zip | 07621-2125
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Country | US
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Telephone | 855-699-7246
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Fax | 718-766-9763
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Provider Business Mailing Address
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Address Line | 185 KINGSLAND ST
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City | NUTLEY
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State | NJ
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Zip | 07110-1119
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Country | US
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Telephone | 855-699-7246
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Fax | 718-766-9763
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LEONID SHAPIRO
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Credential | MD
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Telephone | 855-699-7246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA66044
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License Number State | NJ
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