Provider Demographics
NPI:1760604946
Name:BARRY M. SHAPIRO, M.D., P.C.
Entity Type:Organization
Organization Name:BARRY M. SHAPIRO, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-945-0505
Mailing Address - Street 1:425 N STATE RD
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1469
Mailing Address - Country:US
Mailing Address - Phone:914-945-0505
Mailing Address - Fax:914-945-0828
Practice Address - Street 1:425 N STATE RD
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-1469
Practice Address - Country:US
Practice Address - Phone:914-945-0505
Practice Address - Fax:914-945-0828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY138918207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWDW361Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER