Healthcare Provider Details
I. General information
NPI: 1932220167
Provider Name (Legal Business Name): JAMIE M RAPPAPORT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
JEWISH GENERAL HOSPITAL 3755 COTE ST CATHERINE R
MONTREAL, QB QC
H3T1E2
CA
IV. Provider business mailing address
245 NETHERWOOD CRESCENT
HAMPSTEAD QC
H3X3Y6
CA
V. Phone/Fax
- Phone: 514-340-8246
- Fax:
- Phone: 514-340-8246
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207YX0901X |
| Taxonomy | Otology & Neurotology Physician |
| License Number | 79452 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: