Provider Demographics
NPI:1285939413
Name:SHAPIRO, RICHARD (DPT)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:ARYEH
Other - Middle Name:
Other - Last Name:SHAPIRO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:14440 76TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3116
Mailing Address - Country:US
Mailing Address - Phone:516-784-6633
Mailing Address - Fax:
Practice Address - Street 1:14440 76TH AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3116
Practice Address - Country:US
Practice Address - Phone:516-784-6633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-19
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033416-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist