Provider Demographics
NPI:1508033275
Name:RAPP, NED JR
Entity Type:Individual
Prefix:
First Name:NED
Middle Name:
Last Name:RAPP
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:CLYDE
Other - Middle Name:EDWARD
Other - Last Name:RAPP
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1749 OAKWOOD TERRACE OAK HILL ESTATES
Mailing Address - Street 2:APT 12B
Mailing Address - City:PENN VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19072
Mailing Address - Country:US
Mailing Address - Phone:610-664-2469
Mailing Address - Fax:
Practice Address - Street 1:1749 OAKWOOD TERRACE OAK HILL ESTATES
Practice Address - Street 2:APT 12B
Practice Address - City:PENN VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19072
Practice Address - Country:US
Practice Address - Phone:610-664-2469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD008811E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine