Healthcare Provider Details

I. General information

NPI: 1659305100
Provider Name (Legal Business Name): RICHARD WAYNE RAPKIN PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 11/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 WORLDS FAIR DR SUITE 206
SOMERSET NJ
08873-1369
US

IV. Provider business mailing address

2 WORLDS FAIR DR SUITE 206
SOMERSET NJ
08873-1369
US

V. Phone/Fax

Practice location:
  • Phone: 732-563-4277
  • Fax: 732-563-0161
Mailing address:
  • Phone: 732-563-4277
  • Fax: 732-563-0161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number35SI00299300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number35SI00299300
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number35SI00299300
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number35SI00299300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: