Provider Demographics
NPI:1548589658
Name:RIBIK, CHRISTINE A (OTR/L,CHT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:RIBIK
Suffix:
Gender:F
Credentials:OTR/L,CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10524 ROSEHAVEN ST
Mailing Address - Street 2:APT.215
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2865
Mailing Address - Country:US
Mailing Address - Phone:703-582-4081
Mailing Address - Fax:
Practice Address - Street 1:6900 GEORGIA AVE NW
Practice Address - Street 2:MATC-BLDG. 2A,ROOM 236
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20307-0003
Practice Address - Country:US
Practice Address - Phone:202-356-1012
Practice Address - Fax:202-782-7041
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119002740171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider