MEDICARE: DR. MARTIN ELLIOTT SHAPIRO DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	036379	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215918180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTIN ELLIOTT SHAPIRO DDS

Provider Business Mailing Address
First Line	:	8 CORNELL PL
Second Line	:
City	:	EAST ROCKAWAY
State	:	NY
Zip	:	11518-1306
Country	:	US
Telephone Number	:	516-596-9262
Fax Number	:

Provider Business Practice Location Address
First Line	:	839 UTICA AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-3410
Country	:	US
Telephone Number	:	718-385-3496
Fax Number	:	718-385-3498

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	03/27/2008

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