Provider Demographics
NPI:1952325599
Name:SHAPSIS, ALEXANDER (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:SHAPSIS
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 1:2797 OCEAN PKWY STE 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-7868
Mailing Address - Country:US
Mailing Address - Phone:718-615-4001
Mailing Address - Fax:929-292-9770
Practice Address - Street 1:2797 OCEAN PKWY
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7861
Practice Address - Country:US
Practice Address - Phone:718-615-4000
Practice Address - Fax:718-615-4004
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY239090207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02850879Medicaid
NYI52036Medicare UPIN
NY02850879Medicaid