Provider Demographics
NPI:1730194309
Name:RAPAPORT, ADOLFO (DO)
Entity type:Individual
Prefix:DR
First Name:ADOLFO
Middle Name:
Last Name:RAPAPORT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1440
Mailing Address - Country:US
Mailing Address - Phone:814-375-6560
Mailing Address - Fax:814-372-2848
Practice Address - Street 1:90 BEAVER DR
Practice Address - Street 2:SUITE 211D
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-2440
Practice Address - Country:US
Practice Address - Phone:814-375-6000
Practice Address - Fax:814-375-9503
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-009841-L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000904683OtherBLUE CROSS
PA001672150001Medicaid
PA001672150001Medicaid
PA000904683OtherBLUE CROSS