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Individual

JEROME BARRY SHAPIRO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1049 PARK AVE, NEW YORK, NY 10028-1061
(917) 583-0176
Mailing address
1049 PARK AVE, NEW YORK, NY 10028-1061

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
124545
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00378827
NY
01
04870G
GHI MEDICARE
NY
01
324491
EMPIRE BC/BS
NY
Enumeration date
07/20/2005
Last updated
06/08/2009
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