Provider Demographics
NPI:1831311687
Name:SHAPIRO, FELIKS (MD)
Entity Type:Individual
Prefix:DR
First Name:FELIKS
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1631 ROCKCRESS DR
Mailing Address - Street 2:
Mailing Address - City:JAMISON
Mailing Address - State:PA
Mailing Address - Zip Code:18929-1646
Mailing Address - Country:US
Mailing Address - Phone:215-825-2414
Mailing Address - Fax:
Practice Address - Street 1:1631 ROCKCRESS DR
Practice Address - Street 2:
Practice Address - City:JAMISON
Practice Address - State:PA
Practice Address - Zip Code:18929-1646
Practice Address - Country:US
Practice Address - Phone:215-825-2414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036987E103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE67433Medicare UPIN
PA647154L3XMedicare ID - Type Unspecified