Provider Demographics
NPI:1306961081
Name:DR. ARNOLD SHAPIRO PA
Entity type:Organization
Organization Name:DR. ARNOLD SHAPIRO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:843-860-2644
Mailing Address - Street 1:15 N VIENNA AVE
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08215-3246
Mailing Address - Country:US
Mailing Address - Phone:843-860-2644
Mailing Address - Fax:
Practice Address - Street 1:15N VIENNA AVE
Practice Address - Street 2:
Practice Address - City:EGG HARBOR CITY
Practice Address - State:NJ
Practice Address - Zip Code:08215-3246
Practice Address - Country:US
Practice Address - Phone:843-860-2644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00304000261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1306961082OtherNPI
NJ27TO00012000OtherNEW JERSEY
NJ27OA00304000OtherSTATE LICENSE