Provider Demographics
NPI:1437157799
Name:RAPUANO, CHRISTOPHER JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JOSEPH
Last Name:RAPUANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 WALNUT ST STE 920
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5109
Mailing Address - Country:US
Mailing Address - Phone:215-928-3180
Mailing Address - Fax:215-928-3854
Practice Address - Street 1:840 WALNUT ST STE 920
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5109
Practice Address - Country:US
Practice Address - Phone:215-928-3180
Practice Address - Fax:215-928-3854
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05207200207W00000X
PAMD041715E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012537340004Medicaid
0457039OtherAETNA (ALL STATES)
PA671106OtherBLUE SHIELD
NJ047228Medicare PIN
PA671106OtherBLUE SHIELD
PAE56746Medicare UPIN