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General NPI Number Information
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NPI Number | 1801526777
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Entity Type | Organization
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Legal Business Name | CANNACURE MEDICAL & PAIN MANAGEMENT PC
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Dates
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Enumeration Date | 06/14/2022
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Last Update Date | 06/14/2022
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Provider Practice Location Address
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Address Line | 16059 ROCKAWAY BLVD
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City | JAMAICA
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State | NY
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Zip | 11434-5133
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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 | OWNER
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Name | DR. LEONID SHAPIRO
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Credential | MD
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Telephone | 201-803-0191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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