Provider Demographics
NPI:1497978274
Name:RAPPAPORT, LISA N (PHD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:N
Last Name:RAPPAPORT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 MORRIS PARK AVE RM 2C-31
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1949
Mailing Address - Country:US
Mailing Address - Phone:718-839-7028
Mailing Address - Fax:
Practice Address - Street 1:1225 MORRIS PARK AVE RM 2C-31
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1949
Practice Address - Country:US
Practice Address - Phone:718-839-7028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014122-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist