Individual
MARJORIE RAVITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
260 MIDDLE COUNTRY ROAD, STE 104, SMITHTOWN, NY 11787
(631) 724-1166
(631) 724-4130
Mailing address
260 MIDDLE COUNTRY ROAD, STE 104, SMITHTOWN, NY 11787
(631) 724-1166
(631) 724-4130
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N4126
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01470451
—
NY
01
—
0406805
GHI
NY
01
—
10645
VYTRA
NY
01
—
1C0990
HEALTHNET
NY
01
—
2420175005
CIGNA
NY
01
—
36835P
HIP
NY
01
—
4227812
AETNA
NY
01
—
6C7212
HEALTHNET
NY
01
—
CS989
OXFORD
NY
01
—
P3916310
OXFORD
NY
01
—
PM2951
BLUE CROSS
NY
Enumeration date
10/16/2006
Last updated
09/15/2008
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