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NPI Code Detail

MEDICARE: MR. RALPH CRISTOBAL RPT

MEDICARE: MR. RALPH CRISTOBAL RPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist024709NY

General Provider Information

NPI Number : 1538243274
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RALPH CRISTOBAL RPT
Provider Business Mailing Address
First Line : 402 85TH ST APT 6I
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-4722
Country : US
Telephone Number : 212-473-9155
Fax Number : 212-777-6522
Provider Business Practice Location Address
First Line : 39 E 20TH ST FL 1
Second Line :
City : NEW YORK
State : NY
Zip : 10003-1336
Country : US
Telephone Number : 212-473-9155
Fax Number : 212-777-6522
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 07/08/2007

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