| Doctor Name: | DR. SUSAN SHAPIRO |
| NPI Number: | 1225273725 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 007697 |
| Business Practice Address: | 1668 Mogul Dr Mohegan Lake, NY - 105471848 |
| Business Phone Number: | 9142634978 |
| Business Fax Number: | 9145287818 |
| Mailing Address: | 1668 Mogul Dr, MOHEGAN LAKE |
| State: | NY |
| Postal Code: | 105471848 |
| Phone Number: | 9142634978 |
| Fax Number: | 9145287818 |
| NPI Enumeration Date: | 12/11/2008 |
| NPI Last Update Date: | 12/11/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | 007697 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |