Provider Demographics
NPI:1811329428
Name:CRISCI, RALPH (RT)
Entity type:Individual
Prefix:
First Name:RALPH
Middle Name:
Last Name:CRISCI
Suffix:
Gender:M
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9101 SHORE RD
Mailing Address - Street 2:APT. 406
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-6113
Mailing Address - Country:US
Mailing Address - Phone:347-585-7127
Mailing Address - Fax:
Practice Address - Street 1:9101 SHORE RD
Practice Address - Street 2:APT. 406
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-6113
Practice Address - Country:US
Practice Address - Phone:347-585-7127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY929662247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist