Organization
DR.SHAPIRO EXCEL REHABILITATION PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIKHAIL SHAPIRO DO (MEDICAL DIRECTOR)
(646) 207-0046
Entity
Organization
Contact information
Practice address
3663 ROUTE 9 N STE 103, OLD BRIDGE, NJ 08857-3518
(646) 207-0046
(718) 646-1894
Mailing address
16 LAMOKA AVE, STATEN ISLAND, NY 10308-2025
(646) 207-0046
(718) 646-1894
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
25MB07640400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MB07640400
LISCENCE
NJ
Enumeration date
05/03/2013
Last updated
05/03/2013
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