Provider Demographics
NPI:1720246309
Name:SHAPIRO, MARK (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 MADISON AVENUE 4TH FLOOR
Mailing Address - Street 2:CAROL G. SIMON CANCER CENTER SUITE 4101
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960
Mailing Address - Country:US
Mailing Address - Phone:973-644-4844
Mailing Address - Fax:973-644-4776
Practice Address - Street 1:100 MADISON AVE FL 4
Practice Address - Street 2:CAROL G. SIMON CANCER CENTER SUITE 4101
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6136
Practice Address - Country:US
Practice Address - Phone:973-644-4844
Practice Address - Fax:973-644-4776
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2015-08-14
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA09343600208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)