Provider Demographics
NPI:1124183421
Name:SHAPIRO, JEFFREY A (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:A
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2856 LONG BEACH RD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-2230
Mailing Address - Country:US
Mailing Address - Phone:516-764-7760
Mailing Address - Fax:516-763-0733
Practice Address - Street 1:2856 LONG BEACH RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-2230
Practice Address - Country:US
Practice Address - Phone:516-764-7760
Practice Address - Fax:516-763-0733
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX05198111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX29951Medicare ID - Type Unspecified