Provider Demographics
NPI:1093168478
Name:STANLEY L. RAPAPORT, M.D.
Entity Type:Organization
Organization Name:STANLEY L. RAPAPORT, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:RAPAPORT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-248-8026
Mailing Address - Street 1:3920 E SAN MIGUEL ST
Mailing Address - Street 2:SUITE 129
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-3427
Mailing Address - Country:US
Mailing Address - Phone:719-258-8026
Mailing Address - Fax:
Practice Address - Street 1:3920 E SAN MIGUEL ST
Practice Address - Street 2:SUITE 129
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-3427
Practice Address - Country:US
Practice Address - Phone:719-258-8026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0021427320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities