MEDICARE: DMITRIY SHAPIRO PHARMD

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	183500000X	Pharmacist	056021	NY

General Provider Information

NPI Number	:	1689951691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DMITRIY SHAPIRO PHARMD

Provider Business Mailing Address
First Line	:	1190 GRAVESEND NECK RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4208
Country	:	US
Telephone Number	:	646-643-3208
Fax Number	:

Provider Business Practice Location Address
First Line	:	1190 GRAVESEND NECK RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4208
Country	:	US
Telephone Number	:	646-643-3208
Fax Number	:

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

Provider Enumeration Date	:	11/05/2011
Last Update Date	:	11/05/2011

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Directions to “ DMITRIY SHAPIRO PHARMD” Practice Location

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