Provider Demographics
NPI:1316584683
Name:CRASTO, CRISILDA CHRISTOPHER (PT)
Entity Type:Individual
Prefix:
First Name:CRISILDA
Middle Name:CHRISTOPHER
Last Name:CRASTO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CRISILDA
Other - Middle Name:ANDREA CHRISTOPHER
Other - Last Name:CRASTO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 715868
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19171-0925
Mailing Address - Country:US
Mailing Address - Phone:804-915-1910
Mailing Address - Fax:
Practice Address - Street 1:1115 BOULDERS PKWY STE 100B
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23225-4067
Practice Address - Country:US
Practice Address - Phone:804-915-1910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-05
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23052160292251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic