Provider Demographics
NPI:1588741482
Name:SHURE, GREGORY M (DC)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:M
Last Name:SHURE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 MADISON AVE
Mailing Address - Street 2:SUITE 1012
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1600
Mailing Address - Country:US
Mailing Address - Phone:212-696-9355
Mailing Address - Fax:212-696-0717
Practice Address - Street 1:60 MADISON AVE
Practice Address - Street 2:SUITE 1012
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-1600
Practice Address - Country:US
Practice Address - Phone:212-696-9355
Practice Address - Fax:212-696-0717
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010168-1111NI0900X, 111NN1001X
NJ38MC00632700111NN1001X
CT001952111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
No111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP3430261OtherOXFORD ID #
NY201365799Medicare UPIN