Provider Demographics
NPI:1124076203
Name:SHAPIRO, ARNOLD LARRY (MD)
Entity type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:LARRY
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 1:25 SOUTHERN PKWY
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-1036
Mailing Address - Country:US
Mailing Address - Phone:585-473-3860
Mailing Address - Fax:
Practice Address - Street 1:1644 MONROE AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-1417
Practice Address - Country:US
Practice Address - Phone:585-442-1420
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY116367207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY09768OtherBLUE CROSS/BLUE SHIELD
NY102198CROtherPREFERRED CARE
NY00469356Medicaid
NY102198CROtherPREFERRED CARE
NY09768OtherBLUE CROSS/BLUE SHIELD