Provider Demographics
NPI:1700959368
Name:RALLO, CRAIG (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:
Last Name:RALLO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 RIFKIN CT
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-8841
Mailing Address - Country:US
Mailing Address - Phone:908-839-2487
Mailing Address - Fax:
Practice Address - Street 1:2698 COUNTY RD 516 STE C
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-2305
Practice Address - Country:US
Practice Address - Phone:732-679-1100
Practice Address - Fax:732-679-5770
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010859111N00000X
NJ38MC00625500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ092917Medicare ID - Type Unspecified