Provider Demographics
NPI:1306943840
Name:SHAPIRO, ALLEN (OD)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 MALL WALK
Mailing Address - Street 2:CROSS COUNTY SHOPPING CENTER
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704
Mailing Address - Country:US
Mailing Address - Phone:914-968-2626
Mailing Address - Fax:
Practice Address - Street 1:7 MALL WALK
Practice Address - Street 2:CROSS COUNTY SHOPPING CENTER
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704
Practice Address - Country:US
Practice Address - Phone:914-968-2626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-19
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV002453-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC88501OtherEMPIRE BC/BS
NY0555526OtherAETNA
NY132752088OtherOXFORD
NY132752088OtherUNITED HEALTH CARE
NY0071118OtherGHI
NYC88501Medicare PIN
NY0555526OtherAETNA
NY132752088OtherUNITED HEALTH CARE