Provider Demographics
NPI:1497562631
Name:RAPPAPORT, MOLLY (PHD)
Entity type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:
Last Name:RAPPAPORT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 GATES AVE # 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-1904
Mailing Address - Country:US
Mailing Address - Phone:917-843-8278
Mailing Address - Fax:
Practice Address - Street 1:89 FORT GREENE PL # 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-1203
Practice Address - Country:US
Practice Address - Phone:917-843-8278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026952103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical