MEDICARE: MRS. ABIGAIL E RAPPS OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171W00000X	Contractor	011348-1	NY
2	225XP0200X	Pediatric Occupational Therapist	011348-1	NY

General Provider Information

NPI Number	:	1063659282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ABIGAIL E RAPPS OTR

Provider Business Mailing Address
First Line	:	1337 E 4TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-4605
Country	:	US
Telephone Number	:	718-677-1274
Fax Number	:

Provider Business Practice Location Address
First Line	:	1337 E 4TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-4605
Country	:	US
Telephone Number	:	718-677-1274
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2009
Last Update Date	:	01/09/2009

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