Provider Demographics
NPI:1184777427
Name:JEFFREY RAPAPORT,MD,PA
Entity type:Organization
Organization Name:JEFFREY RAPAPORT,MD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAPAPORT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-227-1555
Mailing Address - Street 1:333 SYLVAN AVE
Mailing Address - Street 2:207
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2724
Mailing Address - Country:US
Mailing Address - Phone:201-227-1555
Mailing Address - Fax:201-227-8477
Practice Address - Street 1:333 SYLVAN AVE
Practice Address - Street 2:207
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2724
Practice Address - Country:US
Practice Address - Phone:201-227-1555
Practice Address - Fax:201-227-8477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA40129207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Multi-Specialty