Provider Demographics
NPI:1427283050
Name:SHAPIRO-BASEN, CARRIE JANINE (MS CCC-A)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:JANINE
Last Name:SHAPIRO-BASEN
Suffix:
Gender:F
Credentials:MS CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1944 CORLIES AVE
Mailing Address - Street 2:AUDIOLOGY DEPARTMENT-SUITE 102
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4862
Mailing Address - Country:US
Mailing Address - Phone:732-776-4960
Mailing Address - Fax:732-776-4181
Practice Address - Street 1:1944 CORLIES AVE
Practice Address - Street 2:AUDIOLOGY DEPARTMENT-SUITE 102
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4862
Practice Address - Country:US
Practice Address - Phone:732-776-4960
Practice Address - Fax:732-776-4181
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41 YA 00054900231H00000X
NJMG 00093100237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter