Provider Demographics
NPI:1518036698
Name:SHAPIRO, EUGENE (DPM)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 OCEAN VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6826
Mailing Address - Country:US
Mailing Address - Phone:718-332-2582
Mailing Address - Fax:718-743-3963
Practice Address - Street 1:301 OCEAN VIEW AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235
Practice Address - Country:US
Practice Address - Phone:718-332-2582
Practice Address - Fax:718-743-3963
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN0041801213E00000X
NY001028-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00989813Medicaid
NY00989813Medicaid
NYP43461Medicare ID - Type Unspecified
NY0735650001Medicare PIN