Provider Demographics
NPI:1134567183
Name:RAPESS-FITZPATRICK, EVANGELINE (OTR)
Entity type:Individual
Prefix:
First Name:EVANGELINE
Middle Name:
Last Name:RAPESS-FITZPATRICK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:952 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NORTH MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-2360
Mailing Address - Country:US
Mailing Address - Phone:516-798-1722
Mailing Address - Fax:516-798-1911
Practice Address - Street 1:952 N BROADWAY
Practice Address - Street 2:
Practice Address - City:NORTH MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-2360
Practice Address - Country:US
Practice Address - Phone:516-798-1722
Practice Address - Fax:516-798-1911
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004255-1224Z00000X
NY028253225XH1200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand