Provider Demographics
NPI:1093866279
Name:SOLDANO, RALPH (OTR)
Entity Type:Individual
Prefix:MR
First Name:RALPH
Middle Name:
Last Name:SOLDANO
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 PHIPPS DR
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-7509
Mailing Address - Country:US
Mailing Address - Phone:203-668-9035
Mailing Address - Fax:
Practice Address - Street 1:113 PHIPPS DR
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-7509
Practice Address - Country:US
Practice Address - Phone:203-668-9035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002432225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist