Provider Demographics
NPI:1598943672
Name:TODD A RELKIN MD PA
Entity Type:Organization
Organization Name:TODD A RELKIN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:A
Authorized Official - Last Name:RELKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-941-5282
Mailing Address - Street 1:540 NE WATERWAY LN
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-2828
Mailing Address - Country:US
Mailing Address - Phone:954-941-5282
Mailing Address - Fax:954-941-5380
Practice Address - Street 1:540 NE WATERWAY LN
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-2828
Practice Address - Country:US
Practice Address - Phone:954-941-5282
Practice Address - Fax:954-941-5380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6506Medicare PIN