Provider Demographics
NPI:1407858731
Name:RAPPOPORT, HARVEY D (OD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:D
Last Name:RAPPOPORT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 RESERVOIR AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-4420
Mailing Address - Country:US
Mailing Address - Phone:401-943-3082
Mailing Address - Fax:401-464-4146
Practice Address - Street 1:950 RESERVOIR AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-4420
Practice Address - Country:US
Practice Address - Phone:401-943-3082
Practice Address - Fax:401-464-4146
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIODTG00342152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIT53556Medicare UPIN
RI41800987AMedicare PIN
RI007058373Medicare PIN