Provider Demographics
NPI:1972177897
Name:RAPAPORT, IRINA (LPN)
Entity type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:RAPAPORT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 SCRIBNER RD
Mailing Address - Street 2:
Mailing Address - City:PENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14526-9752
Mailing Address - Country:US
Mailing Address - Phone:585-315-8922
Mailing Address - Fax:
Practice Address - Street 1:1601 SCRIBNER RD
Practice Address - Street 2:
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-9752
Practice Address - Country:US
Practice Address - Phone:585-315-8922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-15
Last Update Date:2021-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY264166-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse