Provider Demographics
NPI:1962937573
Name:RAPACIOLI, DIANE
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:RAPACIOLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9027 SUTPHIN BLVD
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-3647
Mailing Address - Country:US
Mailing Address - Phone:718-526-8400
Mailing Address - Fax:
Practice Address - Street 1:9027 SUTPHIN BLVD
Practice Address - Street 2:5TH FLOOR
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-3647
Practice Address - Country:US
Practice Address - Phone:718-526-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070395-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical