Provider Demographics
NPI:1528085255
Name:MARGATE, PEDRO R (MD)
Entity type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:R
Last Name:MARGATE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2300
Mailing Address - Street 2:ADVANCED RADIOLOGY
Mailing Address - City:SO VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08362-2300
Mailing Address - Country:US
Mailing Address - Phone:856-293-1632
Mailing Address - Fax:856-293-7810
Practice Address - Street 1:1001 N HIGH ST
Practice Address - Street 2:ADVANCED RADIOLOGY OF MILLVILLE PA
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332
Practice Address - Country:US
Practice Address - Phone:856-825-0005
Practice Address - Fax:856-825-5576
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA027560002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8423300Medicaid
NJ880244CSYMedicare ID - Type Unspecified
NJ8423300Medicaid