MEDICARE: TALIA HANNAH RAPPS LMSW

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	104100000X	Social Worker	081489-01	NY

General Provider Information

NPI Number	:	1780385278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TALIA HANNAH RAPPS LMSW

Provider Business Mailing Address
First Line	:	548 HEMLOCK DR
Second Line	:
City	:	CEDARHURST
State	:	NY
Zip	:	11516-1020
Country	:	US
Telephone Number	:	516-330-5153
Fax Number	:	516-330-5153

Provider Business Practice Location Address
First Line	:	930 BROADWAY
Second Line	:
City	:	WOODMERE
State	:	NY
Zip	:	11598-1766
Country	:	US
Telephone Number	:	516-330-5153
Fax Number	:

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

Provider Enumeration Date	:	03/13/2023
Last Update Date	:	03/13/2023

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