Individual
BO SHOPSIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.-PH.D.
Contact information
Practice address
550 1ST AVE, NEW BELLEVUE, 16, 16S5, NEW YORK, NY 10016-6402
(212) 263-6400
(212) 263-7369
Mailing address
318 E 15TH ST APT 11E, NEW YORK, NY 10003-4015
(212) 263-6400
(212) 263-7369
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
231745
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
231745
STATE LICENSE
NY
Enumeration date
12/20/2006
Last updated
07/08/2007
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