Provider Demographics
NPI:1003806167
Name:RAPOSO, FATIMA (OD)
Entity type:Individual
Prefix:
First Name:FATIMA
Middle Name:
Last Name:RAPOSO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1565 N MAIN ST
Mailing Address - Street 2:STE 406
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-2972
Mailing Address - Country:US
Mailing Address - Phone:508-677-0041
Mailing Address - Fax:508-677-0975
Practice Address - Street 1:1565 N MAIN ST
Practice Address - Street 2:STE 406
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-2972
Practice Address - Country:US
Practice Address - Phone:508-677-0041
Practice Address - Fax:508-677-0975
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4022152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0372081Medicaid
MA0372081Medicaid
U67122Medicare UPIN