Provider Demographics
NPI:1851636518
Name:SHAPIRO, GRAIG HARRIS (DC)
Entity Type:Individual
Prefix:DR
First Name:GRAIG
Middle Name:HARRIS
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 1:1275 FRENCH RD
Mailing Address - Street 2:APARTMENT 5
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-4819
Mailing Address - Country:US
Mailing Address - Phone:734-904-3288
Mailing Address - Fax:
Practice Address - Street 1:1402 FRENCH RD
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-4868
Practice Address - Country:US
Practice Address - Phone:716-668-3072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY70 012263111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician