Provider Demographics
NPI:1588864599
Name:CHRISTEL, RICHARD ROBERT (DMD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:ROBERT
Last Name:CHRISTEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 WEST 57TH STREET
Mailing Address - Street 2:SUITE 1022
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10107-1022
Mailing Address - Country:US
Mailing Address - Phone:212-582-9819
Mailing Address - Fax:
Practice Address - Street 1:250 WEST 57TH STREET
Practice Address - Street 2:SUITE 1022
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10107-1022
Practice Address - Country:US
Practice Address - Phone:212-582-9819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0357691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice