MEDICARE: DR. HARVEY D RAPPOPORT O.D.

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	152W00000X	Optometrist	ODTG00342	RI

General Provider Information

NPI Number	:	1407858731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARVEY D RAPPOPORT O.D.

Provider Business Mailing Address
First Line	:	950 RESERVOIR AVE
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02910-4420
Country	:	US
Telephone Number	:	401-943-3082
Fax Number	:	401-464-4146

Provider Business Practice Location Address
First Line	:	950 RESERVOIR AVE
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02910-4420
Country	:	US
Telephone Number	:	401-943-3082
Fax Number	:	401-464-4146

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	11/16/2007

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