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General NPI Number Information
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NPI Number | 1295916690
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Entity Type | Organization
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Legal Business Name | MEDICAL PSYCHOLOGY ASSOCS., PC
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Dates
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Enumeration Date | 11/14/2007
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Last Update Date | 09/22/2022
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Provider Practice Location Address
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Address Line | 5555 GLENRIDGE CONNECTOR NE 200
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City | ATLANTA
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State | GA
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Zip | 30342-4759
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Country | US
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Telephone | 404-843-4740
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Fax |
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Provider Business Mailing Address
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Address Line | 5555 GLENRIDGE CONNECTOR NE 200
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City | ATLANTA
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State | GA
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Zip | 30342-4759
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Country | US
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Telephone | 404-843-4740
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NEIL BRUCE RAPPAPORT
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Credential | PHD.
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Telephone | 404-843-4740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1550
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License Number State | GA
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