Provider Demographics
NPI:1033399548
Name:DR. HARVEY D. RAPPOPORT PC
Entity Type:Organization
Organization Name:DR. HARVEY D. RAPPOPORT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:D
Authorized Official - Last Name:RAPPOPORT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:401-943-3082
Mailing Address - Street 1:1145 RESERVOIR AVE
Mailing Address - Street 2:SUITE #117
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-6055
Mailing Address - Country:US
Mailing Address - Phone:401-943-3082
Mailing Address - Fax:401-464-4146
Practice Address - Street 1:1145 RESERVOIR AVE
Practice Address - Street 2:SUITE #117
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-6055
Practice Address - Country:US
Practice Address - Phone:401-943-3082
Practice Address - Fax:401-464-4146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIODTG00342152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI007058373Medicare PIN
RI6096340001Medicare NSC
RIT53556Medicare UPIN
RI41800987AMedicare PIN