Provider Demographics
NPI:1801927595
Name:CHRISTOPHER, RUDOLPH FRANCIS (MPT)
Entity type:Individual
Prefix:
First Name:RUDOLPH
Middle Name:FRANCIS
Last Name:CHRISTOPHER
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 N DELSEA DR UNIT B
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08312-1637
Mailing Address - Country:US
Mailing Address - Phone:856-423-7700
Mailing Address - Fax:877-407-4329
Practice Address - Street 1:10 RAMS GATE CT
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-9704
Practice Address - Country:US
Practice Address - Phone:877-407-3422
Practice Address - Fax:877-407-4329
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00810700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ650025934Medicare PIN
NJ059682PCVMedicare ID - Type UnspecifiedPROVIDER NUMBER