Provider Demographics
NPI:1518013382
Name:ARNOLD LARRY SHAPIRO
Entity Type:Organization
Organization Name:ARNOLD LARRY SHAPIRO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:LARRY
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-442-1420
Mailing Address - Street 1:1644 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-1417
Mailing Address - Country:US
Mailing Address - Phone:585-442-1420
Mailing Address - Fax:
Practice Address - Street 1:1644 MONROE AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-1417
Practice Address - Country:US
Practice Address - Phone:585-442-1420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY116367207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00463956Medicaid
NY14234AMedicare ID - Type Unspecified
NYC58300Medicare UPIN
NY0884060001Medicare NSC