Provider Demographics
NPI:1851303499
Name:RAPS, CHARLES S (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:S
Last Name:RAPS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:107 BAYVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-1510
Mailing Address - Country:US
Mailing Address - Phone:631-869-5625
Mailing Address - Fax:631-757-5115
Practice Address - Street 1:256 MAIN ST
Practice Address - Street 2:ROOM 205
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-1733
Practice Address - Country:US
Practice Address - Phone:631-757-5115
Practice Address - Fax:631-757-5115
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005732103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical