Provider Demographics
NPI:1922194075
Name:SHAPIRO, LEE S (MD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:S
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:711 TROY SCHENECTADY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2461
Mailing Address - Country:US
Mailing Address - Phone:518-782-3799
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:1 WEST AVE STE 330
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-6065
Practice Address - Country:US
Practice Address - Phone:518-782-3899
Practice Address - Fax:518-782-3885
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY149404207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00697874Medicaid
NY00697874Medicaid