Provider Demographics
NPI:1841995925
Name:RIJOS, CHRYSTAL ELISE
Entity type:Individual
Prefix:
First Name:CHRYSTAL
Middle Name:ELISE
Last Name:RIJOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 ACORN TER
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5901
Mailing Address - Country:US
Mailing Address - Phone:845-270-1862
Mailing Address - Fax:
Practice Address - Street 1:3 ACORN TER
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5901
Practice Address - Country:US
Practice Address - Phone:845-270-1862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT01460800225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist