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General NPI Number Information
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NPI Number | 1992754634
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Entity Type | Individual
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Provider Name | LEONID SHAPIRO MD
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Gender | Male
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 09/11/2018
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Provider Practice Location Address
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Address Line | 790 BLOOMFIELD AVE
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City | CLIFTON
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State | NJ
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Zip | 07012-1142
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Country | US
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Telephone | 201-448-4100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 334
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City | TENAFLY
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State | NJ
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Zip | 07670-0334
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Country | US
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Telephone | 201-803-0191
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Fax | 201-608-7171
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25MA06604400
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License Number State | NJ
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