Provider Demographics
NPI:1598918559
Name:SHAPIRO, MIRIAM (CRNP)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 MARLTON PIKE E
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-2408
Mailing Address - Country:US
Mailing Address - Phone:856-528-5370
Mailing Address - Fax:856-528-5375
Practice Address - Street 1:325 MARLTON PIKE E
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034
Practice Address - Country:US
Practice Address - Phone:856-528-5370
Practice Address - Fax:856-528-5375
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00399400363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics