Provider Demographics
NPI:1801526777
Name:CANNACURE MEDICAL & PAIN MANAGEMENT PC
Entity type:Organization
Organization Name:CANNACURE MEDICAL & PAIN MANAGEMENT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONID
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-803-0191
Mailing Address - Street 1:185 KINGSLAND ST
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1119
Mailing Address - Country:US
Mailing Address - Phone:855-699-7246
Mailing Address - Fax:718-766-9763
Practice Address - Street 1:16059 ROCKAWAY BLVD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-5133
Practice Address - Country:US
Practice Address - Phone:855-699-7246
Practice Address - Fax:718-766-9763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty