Provider Demographics
NPI:1831334200
Name:BELLA SHAPNIK, MD, PA
Entity type:Organization
Organization Name:BELLA SHAPNIK, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE, MD PA
Authorized Official - Prefix:DR
Authorized Official - First Name:BELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPNIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-461-2444
Mailing Address - Street 1:2150 CENTER AVE STE 1B
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-5806
Mailing Address - Country:US
Mailing Address - Phone:201-461-2444
Mailing Address - Fax:201-461-7148
Practice Address - Street 1:2150 CENTER AVE STE 1B
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-5806
Practice Address - Country:US
Practice Address - Phone:201-461-2444
Practice Address - Fax:201-461-7148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-12
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1831334200OtherNPI
NJ1831334200OtherNPI