Provider Demographics
NPI:1164420493
Name:SHAPIRO, EVAN BRUCE (MD)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:BRUCE
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1300 UNION TPKE STE 206
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1759
Mailing Address - Country:US
Mailing Address - Phone:516-208-7600
Mailing Address - Fax:516-519-8818
Practice Address - Street 1:1300 UNION TPKE STE 206
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1759
Practice Address - Country:US
Practice Address - Phone:516-208-7600
Practice Address - Fax:516-519-8818
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY152497207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology