Provider Demographics
NPI:1265581714
Name:SHAPIRO, SOFIA (MD)
Entity type:Individual
Prefix:DR
First Name:SOFIA
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 S ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-2636
Mailing Address - Country:US
Mailing Address - Phone:973-763-8950
Mailing Address - Fax:973-763-5216
Practice Address - Street 1:511 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-2636
Practice Address - Country:US
Practice Address - Phone:973-763-8950
Practice Address - Fax:973-763-5216
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA069937207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine