Individual
DR. EDITH TENNENBAUM SHAPIRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 ENGLE ST, SUITE 27, ENGLEWOOD, NJ 07631-2440
(201) 871-3027
(201) 569-7264
Mailing address
277 S BROADWAY, APT. E, TARRYTOWN, NY 10591-5334
(914) 332-1755
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
25MA02257400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015271
GHI
NJ
01
—
050643
VALUE OPTIONS
NJ
01
—
229708
COMPSYCH
NJ
Enumeration date
11/21/2006
Last updated
07/08/2007
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