Healthcare Provider Details

I. General information

NPI: 1548589658
Provider Name (Legal Business Name): CHRISTINE A RIBIK OTR/L,CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2010
Last Update Date: 05/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 GEORGIA AVE NW MATC-BLDG. 2A,ROOM 236
WASHINGTON DC
20307-0003
US

IV. Provider business mailing address

10524 ROSEHAVEN ST APT.215
FAIRFAX VA
22030-2865
US

V. Phone/Fax

Practice location:
  • Phone: 202-356-1012
  • Fax: 202-782-7041
Mailing address:
  • Phone: 703-582-4081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number0119002740
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: