MEDICARE: RIMMA SHAPIRO MSED

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	171M00000X	Case Manager/Care Coordinator	NY
2	390200000X	Student in an Organized Health Care Education/Training Program	NY
3	174400000X	Specialist

General Provider Information

NPI Number	:	1912472127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RIMMA SHAPIRO MSED

Provider Business Mailing Address
First Line	:	4246 SURF AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-1038
Country	:	US
Telephone Number	:	646-327-5039
Fax Number	:

Provider Business Practice Location Address
First Line	:	4246 SURF AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-1038
Country	:	US
Telephone Number	:	646-327-5039
Fax Number	:

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

Provider Enumeration Date	:	10/04/2018
Last Update Date	:	10/04/2018

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Directions to “ RIMMA SHAPIRO MSED” Practice Location

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