Provider Demographics
NPI:1225269400
Name:ANGERSBACH, RALPH
Entity Type:Individual
Prefix:MR
First Name:RALPH
Middle Name:
Last Name:ANGERSBACH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170B MAIN ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-3541
Mailing Address - Country:US
Mailing Address - Phone:732-414-9423
Mailing Address - Fax:732-334-0809
Practice Address - Street 1:170B MAIN ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-3541
Practice Address - Country:US
Practice Address - Phone:732-414-9423
Practice Address - Fax:732-334-0809
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJABMP468086225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist