Provider Demographics
NPI:1891531174
Name:SHAPIRO, STEPHANIE LAUREN (OD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:LAUREN
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-9317
Mailing Address - Country:US
Mailing Address - Phone:732-850-5673
Mailing Address - Fax:
Practice Address - Street 1:510 CONSUMER SQUARE
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330
Practice Address - Country:US
Practice Address - Phone:609-641-1496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OM00197000152W00000X
NJ27OA00729600152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist