Provider Demographics
NPI:1003366600
Name:RAPPOLD, MICHAEL R (PA-C)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:R
Last Name:RAPPOLD
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:99 PARK AVE FL 20
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-1601
Mailing Address - Country:US
Mailing Address - Phone:212-972-4444
Mailing Address - Fax:212-972-4468
Practice Address - Street 1:99 PARK AVE FL 20
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-1601
Practice Address - Country:US
Practice Address - Phone:212-972-4444
Practice Address - Fax:212-972-4468
Is Sole Proprietor?:No
Enumeration Date:2016-10-06
Last Update Date:2018-04-30
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Provider Licenses
StateLicense IDTaxonomies
NY363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant