=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437157799
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTOPHER JOSEPH RAPUANO MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/11/2005
-----------------------------------------------------
Last Update Date | 06/19/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 840 WALNUT ST STE 920
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19107-5109
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-928-3180
-----------------------------------------------------
Fax | 215-928-3854
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 840 WALNUT ST STE 920
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19107-5109
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-928-3180
-----------------------------------------------------
Fax | 215-928-3854
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | 25MA05207200
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | MD041715E
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------