Provider Demographics
NPI:1073785994
Name:SHAPIRO, NATASHA ELENA ELIZAVETA (LCAT, ATR-BC)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:ELENA ELIZAVETA
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:LCAT, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:368 BROADWAY
Mailing Address - Street 2:SUITE 307
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-3935
Mailing Address - Country:US
Mailing Address - Phone:917-374-7082
Mailing Address - Fax:
Practice Address - Street 1:368 BROADWAY
Practice Address - Street 2:SUITE 307
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-3935
Practice Address - Country:US
Practice Address - Phone:917-374-7082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000022221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist