Healthcare Provider Details

I. General information

NPI: 1457532970
Provider Name (Legal Business Name): CHRISTINA RAPP PRESCOTT M.D., PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS CHRISTINA DEMONT RAPP

II. Dates (important events)

Enumeration Date: 11/27/2007
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 E 41ST ST FL 4
NEW YORK NY
10017-6739
US

IV. Provider business mailing address

620 BOULTON ST
BEL AIR MD
21014-4255
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-2573
  • Fax:
Mailing address:
  • Phone: 410-836-7010
  • Fax: 410-893-9796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number247054
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: