Provider Demographics
NPI:1013935428
Name:RAPPAPORT, MARCIA (RD, CDN, IBCLC)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:RAPPAPORT
Suffix:
Gender:F
Credentials:RD, CDN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-4716
Mailing Address - Country:US
Mailing Address - Phone:845-358-2641
Mailing Address - Fax:
Practice Address - Street 1:36 CLINTON AVE
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-4716
Practice Address - Country:US
Practice Address - Phone:845-358-2641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY894883-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered