Provider Demographics
NPI:1124447453
Name:SHAPIRO, KATHERINE KAISER (MD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:KAISER
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:453 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-2019
Mailing Address - Country:US
Mailing Address - Phone:908-722-6900
Mailing Address - Fax:551-310-6754
Practice Address - Street 1:453 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2019
Practice Address - Country:US
Practice Address - Phone:908-722-6900
Practice Address - Fax:551-310-6754
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA11683700208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology