Provider Demographics
NPI:1033311659
Name:RAPISARDI, DORIS A (MAS CCC A)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:A
Last Name:RAPISARDI
Suffix:
Gender:F
Credentials:MAS CCC A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 RT. 46 W
Mailing Address - Street 2:STE. 9-#115
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866
Mailing Address - Country:US
Mailing Address - Phone:973-927-3433
Mailing Address - Fax:973-927-3473
Practice Address - Street 1:860 ROUTE #10 WEST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869
Practice Address - Country:US
Practice Address - Phone:973-927-3433
Practice Address - Fax:973-927-3473
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0041YA00149231H00000X
NJ25MG00614237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP3599374OtherOXFORD UHC
NJ375083OtherAETNA
NJ0060127Medicaid
NJ7324596OtherHORIZON BCBS
NJ375083OtherAETNA