Provider Demographics
NPI:1346272689
Name:SHAPIRO, PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 CENTRAL PARK WEST
Mailing Address - Street 2:SUITE 1-BW
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6038
Mailing Address - Country:US
Mailing Address - Phone:212-305-9985
Mailing Address - Fax:212-305-1249
Practice Address - Street 1:239 CENTRAL PARK WEST
Practice Address - Street 2:SUITE 1-BW
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6038
Practice Address - Country:US
Practice Address - Phone:212-305-9985
Practice Address - Fax:212-305-1249
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1466402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00874479Medicaid
NY00874479Medicaid
NY20D991Medicare ID - Type Unspecified
NY20D992Medicare ID - Type Unspecified