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Organization
VANGUARD DERMATOLOGY
Active
Organization
VANGUARD DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL SHAPIRO MD (PRESIDENT)
(718) 332-2999
Entity
Organization
Contact information
Practice address
11045 QUEENS BLVD, UNIT 116, FOREST HILLS, NY 11375-5501
(718) 332-2999
Mailing address
14568 3RD AVE, WHITESTONE, NY 11357-1101
(718) 332-2999
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02692937
—
NY
Enumeration date
10/09/2007
Last updated
10/09/2007
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