Provider Demographics
NPI:1639358120
Name:RONALD JAY RAPOPORT, MD
Entity Type:Organization
Organization Name:RONALD JAY RAPOPORT, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:RAPOPORT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-676-3411
Mailing Address - Street 1:1030 PRESIDENT AVE
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-5923
Mailing Address - Country:US
Mailing Address - Phone:508-676-3411
Mailing Address - Fax:508-676-6277
Practice Address - Street 1:1030 PRESIDENT AVE
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5923
Practice Address - Country:US
Practice Address - Phone:508-676-3411
Practice Address - Fax:508-676-6277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA44177207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAD82939Medicare UPIN
MAM13257Medicare PIN