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General NPI Number Information
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NPI Number | 1942519095
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Entity Type | Individual
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Provider Name | JEFFREY BEN RAPPAPORT D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 10/06/2010
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Last Update Date | 01/08/2019
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Provider Practice Location Address
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Address Line | 474 6TH AVE
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City | NEW YORK
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State | NY
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Zip | 10011-8414
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Country | US
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Telephone | 212-837-1833
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Fax |
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Provider Business Mailing Address
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Address Line | 330 E 72ND ST
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City | NEW YORK
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State | NY
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Zip | 10021-4700
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Country | US
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Telephone | 413-530-2228
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 054586-1
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License Number State | NY
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