Provider Demographics
NPI:1811124746
Name:SHAPIRO, EUGENE (MD)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:
Last Name:SHAPIRO
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 1:525 OCEAN BLVD
Mailing Address - Street 2:APT. # 507
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-8907
Mailing Address - Country:US
Mailing Address - Phone:732-887-5285
Mailing Address - Fax:609-896-4296
Practice Address - Street 1:132 FRANKLIN CORNER RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2523
Practice Address - Country:US
Practice Address - Phone:609-896-3808
Practice Address - Fax:609-896-4296
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08515800208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics