Provider Demographics
NPI:1255309316
Name:SHAPIRO, GEOFFREY IRA (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:IRA
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 BROOKLINE AVE, M446
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5418
Mailing Address - Country:US
Mailing Address - Phone:617-632-4942
Mailing Address - Fax:617-632-1977
Practice Address - Street 1:450 BROOKLINE AVE # M446
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5418
Practice Address - Country:US
Practice Address - Phone:617-632-4942
Practice Address - Fax:617-632-1977
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA74477207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
6316537OtherCIGNA
E91385DFOtherHPHC DFCI ONLY
P00122121OtherRR MEDICARE DFCI
3040037OtherUNITED HEALTH CARE
3163733OtherMASSHEALTH MA MEDICAID
J11339OtherMA BLUE CROSS BLUE SHIELD
65573OtherFALLON COMM HEALTH PLAN
074477OtherTUFTS
P00078764OtherRR MEDICARE BINNEY MED
2067442OtherAETNA US HEALTHCARE
J11339Medicare ID - Type Unspecified
E91385DFOtherHPHC DFCI ONLY