Provider Demographics
NPI:1437229374
Name:RAPPAPORT, ALISHA SUE (MA, ATR-BC, LCAT)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:SUE
Last Name:RAPPAPORT
Suffix:
Gender:F
Credentials:MA, ATR-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 E MILL DR
Mailing Address - Street 2:APT 3G
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-4007
Mailing Address - Country:US
Mailing Address - Phone:516-773-3308
Mailing Address - Fax:
Practice Address - Street 1:56-45 MAIN STREET
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-670-2920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000017221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist