Provider Demographics
NPI:1467538694
Name:SHAPIRO, GEORGE EUGENE (PHD PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:EUGENE
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:PHD PSYCHOLOGIST
Other - Prefix:
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Mailing Address - Street 1:ONE IPSWICH AVE
Mailing Address - Street 2:328
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-3263
Mailing Address - Country:US
Mailing Address - Phone:516-487-1328
Mailing Address - Fax:516-466-2993
Practice Address - Street 1:211 W 56 ST
Practice Address - Street 2:APT 5K
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10019-4312
Practice Address - Country:US
Practice Address - Phone:212-307-0582
Practice Address - Fax:516-466-2993
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-08-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY0033271103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
V921XOtherEMPIRE BLUE CROSS BLUE SH
V1005OtherEMPIRE BCBS
V10052Medicare ID - Type Unspecified
V921XOtherEMPIRE BLUE CROSS BLUE SH