Provider Demographics
NPI:1629013933
Name:RAPPAPORT, LIVIU (MD)
Entity type:Individual
Prefix:DR
First Name:LIVIU
Middle Name:
Last Name:RAPPAPORT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LB# 7550, P.O. BOX 95000
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-7550
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:508 HAMBURG TURNPIKE
Practice Address - Street 2:SUITE 202
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2025
Practice Address - Country:US
Practice Address - Phone:973-956-1404
Practice Address - Fax:973-956-1646
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05724200207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2110393OtherAETNA
NJ99936OtherAMERIGROUP
NJJ5518OtherHORIZON HMO BLUE
NJ2K2751OtherHEALTHNET
NJ9C1761OtherEMPIRE BLUE SHIELD
NJ01702661Medicaid
NJP782845OtherOXFORD
NJ2110393OtherAETNA
NJ2K2751OtherHEALTHNET