Provider Demographics
NPI:1932192143
Name:RAPS, MITCHELL S (MD)
Entity Type:Individual
Prefix:
First Name:MITCHELL
Middle Name:S
Last Name:RAPS
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 1:110 E 82ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0801
Mailing Address - Country:US
Mailing Address - Phone:212-860-1900
Mailing Address - Fax:212-860-3517
Practice Address - Street 1:110 E 82ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0801
Practice Address - Country:US
Practice Address - Phone:212-860-1900
Practice Address - Fax:212-860-3517
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-24
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1467472084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00885676Medicaid
NYNS4582OtherOXFORD PROVIDER#
NY00885676Medicaid
NYB14517Medicare UPIN