Provider Demographics
NPI:1073870861
Name:SHAPIRO, KAREN
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:ELINOR
Other - Last Name:SHAPIRO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:81 MIDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-5607
Mailing Address - Country:US
Mailing Address - Phone:201-833-5992
Mailing Address - Fax:201-833-5992
Practice Address - Street 1:425 W 130TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-7500
Practice Address - Country:US
Practice Address - Phone:212-690-5932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008379-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist