Provider Demographics
NPI:1972121184
Name:SHAPIRO, SABRINA UDELL (SPT)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:UDELL
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:SPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18022 CHALET DR APT 204
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-5892
Mailing Address - Country:US
Mailing Address - Phone:301-641-7638
Mailing Address - Fax:
Practice Address - Street 1:20500 SENECA MEADOWS PKWY STE 101
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-7009
Practice Address - Country:US
Practice Address - Phone:301-916-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program