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General NPI Number Information
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NPI Number | 1184014011
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Entity Type | Organization
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Legal Business Name | KTHRYN P. RAPPERPORT, MD, PC
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Dates
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Enumeration Date | 01/30/2015
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Last Update Date | 01/30/2015
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Provider Practice Location Address
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Address Line | 8 WALLIS CT
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City | LEXINGTON
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State | MA
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Zip | 02421-5417
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Country | US
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Telephone | 781-862-7487
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Fax |
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Provider Business Mailing Address
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Address Line | 8 WALLIS CT
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City | LEXINGTON
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State | MA
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Zip | 02421-5417
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Country | US
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Telephone | 781-862-7487
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KATHRYN PORTER RAPPERPORT
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Credential | MD
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Telephone | 781-862-7487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number | 78675
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License Number State | MA
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