Provider Demographics
NPI:1962565762
Name:MARGARET RAVITS MD
Entity type:Organization
Organization Name:MARGARET RAVITS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:S
Authorized Official - Last Name:RAVITS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-616-7117
Mailing Address - Street 1:130 KINDERKAMACK RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661-1939
Mailing Address - Country:US
Mailing Address - Phone:201-692-0800
Mailing Address - Fax:201-488-1582
Practice Address - Street 1:130 KINDERKAMACK RD
Practice Address - Street 2:SUITE 205
Practice Address - City:RIVER EDGE
Practice Address - State:NJ
Practice Address - Zip Code:07661-1939
Practice Address - Country:US
Practice Address - Phone:973-616-7117
Practice Address - Fax:973-616-7338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03515600207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ647989Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER
NJC52941Medicare UPIN