Provider Demographics
NPI:1760671580
Name:SHAPIRO, WALTER (DC)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-1928
Mailing Address - Country:US
Mailing Address - Phone:607-433-1150
Mailing Address - Fax:607-433-5298
Practice Address - Street 1:427 MAIN ST
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-1928
Practice Address - Country:US
Practice Address - Phone:607-433-1150
Practice Address - Fax:607-433-5298
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2011-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009203111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRB6685Medicare PIN
NYU74379Medicare UPIN
NYX2200YPXW1Medicare PIN