Provider Demographics
NPI:1538243274
Name:CRISTOBAL, RALPH (RPT)
Entity type:Individual
Prefix:MR
First Name:RALPH
Middle Name:
Last Name:CRISTOBAL
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:MR
Other - First Name:RALPH
Other - Middle Name:
Other - Last Name:CRISTOBAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPT
Mailing Address - Street 1:402 85TH ST APT 6I
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-4722
Mailing Address - Country:US
Mailing Address - Phone:212-473-9155
Mailing Address - Fax:212-777-6522
Practice Address - Street 1:39 E 20TH ST FL 1
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-1336
Practice Address - Country:US
Practice Address - Phone:212-473-9155
Practice Address - Fax:212-777-6522
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024709225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist