Provider Demographics
NPI:1548562564
Name:RAPAPORT, SONIA GLENE (PT)
Entity Type:Individual
Prefix:MS
First Name:SONIA
Middle Name:GLENE
Last Name:RAPAPORT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 AUBREY RD
Mailing Address - Street 2:
Mailing Address - City:UPPER MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-2202
Mailing Address - Country:US
Mailing Address - Phone:201-602-4380
Mailing Address - Fax:
Practice Address - Street 1:32 AUBREY RD
Practice Address - Street 2:
Practice Address - City:UPPER MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-2202
Practice Address - Country:US
Practice Address - Phone:201-602-4380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00513000225100000X
NY6651-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist