Provider Demographics
NPI:1043204084
Name:SHAPIRO, DEBORAH A (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1035
Mailing Address - Country:US
Mailing Address - Phone:845-353-5600
Mailing Address - Fax:845-987-5979
Practice Address - Street 1:2 CROSFIELD AVE
Practice Address - Street 2:STE 318
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-2226
Practice Address - Country:US
Practice Address - Phone:845-353-5600
Practice Address - Fax:845-353-5668
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1833031207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1322995699OtherHUDSON HEALTH PLAN
560770OtherAETNA USHC
132995699OtherCIGNA PPO
5902155OtherAETNA
0042834OtherGHI HMO
132995699OtherHORIZON HEALTHCARE OF NY
1531349005OtherCIGNA HMO POS
15J091OtherBC BS EMPIRE
183303OtherLICENSE NUMBER
040426011832OtherFIDELIS MEDICAID HMO
0D0701OtherHEALTHNET OF THE NORTH EA
132995699OtherINDECS
9662948OtherGHI
1322995699OtherFAM HEALTH PLUS HUDSON HP
132995699OtherBEECH STREET NETWORK
NY01732594Medicaid
132995699OtherHEALTH NOW
42005POtherHIP
132995699OtherCIGNA PPO
42005POtherHIP