Provider Demographics
NPI:1750893822
Name:RAPPAPORT KIP PLLC
Entity type:Organization
Organization Name:RAPPAPORT KIP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HRIVNAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-747-5050
Mailing Address - Street 1:2219 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-2483
Mailing Address - Country:US
Mailing Address - Phone:775-777-9669
Mailing Address - Fax:775-778-9559
Practice Address - Street 1:2219 N 5TH ST
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-2483
Practice Address - Country:US
Practice Address - Phone:775-777-9669
Practice Address - Fax:775-778-9559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-30
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6342207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty