Individual
DR. ELLIOT J RAPOPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
301 JOHNSON STREET, SANTA FE, NM 87501-1828
(505) 983-3757
(505) 982-3300
Mailing address
301 JOHNSON STREET, SANTA FE, NM 87501-1828
(505) 983-3757
(505) 982-3300
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
NMBPE 225
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201008088
PRESBYTERIAN HEALTH PLAN
—
01
—
N915
BCBS
—
Enumeration date
08/29/2006
Last updated
08/10/2010
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