Provider Demographics
NPI:1073786059
Name:SHAPIRO, VIVIAN (OTR/L)
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 GLENWOOD AVENUE
Mailing Address - Street 2:APT. #403
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306
Mailing Address - Country:US
Mailing Address - Phone:201-230-7262
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF VETERANS AFFAIRS MEDICAL CTR
Practice Address - Street 2:423 EAST 23RD STREET
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10160-0001
Practice Address - Country:US
Practice Address - Phone:212-686-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015066-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist