Provider Demographics
NPI:1043208630
Name:SHAPERO, CRAIG ALAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:ALAN
Last Name:SHAPERO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 CENTRE DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-1501
Mailing Address - Country:US
Mailing Address - Phone:609-860-9111
Mailing Address - Fax:609-860-9311
Practice Address - Street 1:18 CENTRE DR
Practice Address - Street 2:SUITE 203
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831-1501
Practice Address - Country:US
Practice Address - Phone:609-860-9111
Practice Address - Fax:609-860-9311
Is Sole Proprietor?:No
Enumeration Date:2005-10-09
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00250800213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU80515Medicare UPIN