Basic Information
| Provider Information | |||||||||
| NPI: | 1861420374 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHAPIRA | ||||||||
| FirstName: | OZ | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 88 E NEWTON ST | ||||||||
| Address2: | ROBINSON B402 | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021182658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176387350 | ||||||||
| FaxNumber: | 6176387228 | ||||||||
| Practice Location | |||||||||
| Address1: | 88 E NEWTON ST | ||||||||
| Address2: | ROBINSON B402 | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021182658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176387350 | ||||||||
| FaxNumber: | 6176387228 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208G00000X | 78090 | MA | Y | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
ID Information
| ID | Type | State | Issuer | Description | 3116174 | 05 | MA | MEDICAID |