Provider Demographics
NPI:1265650402
Name:SHAPIRO, DAVID (OT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 PALMER RD
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-1819
Mailing Address - Country:US
Mailing Address - Phone:609-466-4079
Mailing Address - Fax:
Practice Address - Street 1:2 DEERPARK DR
Practice Address - Street 2:
Practice Address - City:MONMOUTH JCT
Practice Address - State:NJ
Practice Address - Zip Code:08852-1919
Practice Address - Country:US
Practice Address - Phone:732-274-1122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00114800225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist