Provider Demographics
NPI:1144658931
Name:SHAPOFF, STEPHENIE (PNP)
Entity type:Individual
Prefix:
First Name:STEPHENIE
Middle Name:
Last Name:SHAPOFF
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:STEPHENIE
Other - Middle Name:
Other - Last Name:DRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PNP
Mailing Address - Street 1:420 W 23RD ST APT AGF
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-2100
Mailing Address - Country:US
Mailing Address - Phone:212-473-4200
Mailing Address - Fax:212-473-5696
Practice Address - Street 1:67 IRVING PL
Practice Address - Street 2:3RD FLOOR SOUTH
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2202
Practice Address - Country:US
Practice Address - Phone:212-473-4200
Practice Address - Fax:212-473-5696
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-15
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF382411363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics