Provider Demographics
NPI:1942336516
Name:SHACHTER, NEIL S (MD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:S
Last Name:SHACHTER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:15300 JOG RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-2162
Mailing Address - Country:US
Mailing Address - Phone:561-637-6033
Mailing Address - Fax:561-637-6035
Practice Address - Street 1:15300 JOG RD
Practice Address - Street 2:SUITE 202
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-2162
Practice Address - Country:US
Practice Address - Phone:561-637-6033
Practice Address - Fax:561-637-6035
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2023-12-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN036166001207RC0000X
IL036166001207RC0000X
NY165820207RC0000X, 2083P0901X
MDD87110207RC0000X
FLME1003822083P0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01618042Medicaid
FLAS1036Medicare UPIN