Provider Demographics
NPI:1730220443
Name:SHAPIRO, ROBERTA F (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERTA
Middle Name:F
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:115 E 61ST ST
Mailing Address - Street 2:SUITE 10A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-8183
Mailing Address - Country:US
Mailing Address - Phone:212-888-4635
Mailing Address - Fax:212-888-4637
Practice Address - Street 1:115 E 61ST ST
Practice Address - Street 2:SUITE 10A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-8183
Practice Address - Country:US
Practice Address - Phone:212-888-4635
Practice Address - Fax:212-888-4637
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1793172081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF19332Medicare UPIN