Provider Demographics
NPI:1164644696
Name:MARGATE PAIN TREATMENT CENTER, INC.
Entity Type:Organization
Organization Name:MARGATE PAIN TREATMENT CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:RIDKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-432-6021
Mailing Address - Street 1:P.O. BOX 1623
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33443
Mailing Address - Country:US
Mailing Address - Phone:561-432-6021
Mailing Address - Fax:
Practice Address - Street 1:101 NORTH STATE ROAD 7
Practice Address - Street 2:SUITE 109
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063
Practice Address - Country:US
Practice Address - Phone:954-957-7463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLEE866AMedicare PIN