Provider Demographics
NPI:1053429142
Name:SHAPIRO, MARCUS NATHAN (DPM)
Entity type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:NATHAN
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:DPM
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Other - Credentials:
Mailing Address - Street 1:16216 UNION TPKE STE 306
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1960
Mailing Address - Country:US
Mailing Address - Phone:718-380-7900
Mailing Address - Fax:718-380-5322
Practice Address - Street 1:2791 JERUSALEM AVE
Practice Address - Street 2:
Practice Address - City:NORTH BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-1833
Practice Address - Country:US
Practice Address - Phone:516-826-9000
Practice Address - Fax:516-826-9036
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYN0058591213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPJ9881Medicare ID - Type Unspecified
NYU71895Medicare UPIN