Individual
CARRIE BRENDA RUZAL-SHAPIRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
630 W 168TH ST # MC28, NEW YORK, NY 10032-3725
(212) 305-1948
(212) 305-5777
Mailing address
630 W 168TH ST # MC28, NEW YORK, NY 10032-3725
(212) 305-1948
(212) 305-5777
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
154976
NY
2085R0202X
Diagnostic Radiology Physician
Primary
154976
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01086740
—
NY
01
—
02186203
MEDICAID GROUP #
NY
01
—
W35021
MEDICARE GROUP #
NY
Enumeration date
07/01/2006
Last updated
05/14/2025
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