Provider Demographics
NPI:1598706608
Name:SHIFRIN, CAREY MCNEILL (OD)
Entity Type:Individual
Prefix:DR
First Name:CAREY
Middle Name:MCNEILL
Last Name:SHIFRIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:CAREY
Other - Middle Name:ELIZABETH
Other - Last Name:MCNEILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:307 E SOUTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-5201
Mailing Address - Country:US
Mailing Address - Phone:480-967-4801
Mailing Address - Fax:480-967-2845
Practice Address - Street 1:9336E RAINTREE DR 140
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-7323
Practice Address - Country:US
Practice Address - Phone:480-614-0055
Practice Address - Fax:480-614-6393
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEI3-0001286152W00000X
AZ1564152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1564OtherSTATE BOARD OF OPTOMETRY-AZ
DE015020S05Medicare ID - Type Unspecified
AZ1564OtherSTATE BOARD OF OPTOMETRY-AZ