Provider Demographics
NPI:1497563423
Name:SHOR, IZIPORA
Entity type:Individual
Prefix:
First Name:IZIPORA
Middle Name:
Last Name:SHOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TZIPI
Other - Middle Name:
Other - Last Name:SHOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:163 WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-1105
Mailing Address - Country:US
Mailing Address - Phone:718-772-8039
Mailing Address - Fax:
Practice Address - Street 1:163 WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-1105
Practice Address - Country:US
Practice Address - Phone:718-772-8039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist