Individual
DR. MIRIAM RACHEL RAPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
36 7TH AVE, SUITE 416, NEW YORK, NY 10011-6609
(212) 243-7522
(646) 486-4681
Mailing address
36 7TH AVE, SUITE 416, NEW YORK, NY 10011-6609
(212) 243-7522
(646) 486-4681
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
215452
NY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
61945
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02364583
—
NY
01
—
215452
LICENSE
NY
01
—
61945
LICENSE
NJ
Enumeration date
07/05/2006
Last updated
07/08/2007
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