Provider Demographics
NPI:1285751115
Name:RAPPAPORT, NEIL BRUCE (PHD)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:BRUCE
Last Name:RAPPAPORT
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:5555 GLENRIDGE CONNECTOR NE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-4759
Mailing Address - Country:US
Mailing Address - Phone:404-843-4740
Mailing Address - Fax:404-843-4741
Practice Address - Street 1:5555 GLENRIDGE CONNECTOR NE
Practice Address - Street 2:SUITE 200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-4759
Practice Address - Country:US
Practice Address - Phone:404-843-4740
Practice Address - Fax:404-843-4741
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA1550103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA68BBCGQMedicare ID - Type Unspecified