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Individual

TODD W RIDKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3400 CIVIC CENTER BLVD., 1-330S PERELMAN CENTER, PHILADELPHIA, PA 19104-4306
(215) 662-2737
Mailing address
3400 CIVIC CENTER BLVD, 1-330S PERELMAN CENTER, PHILADELPHIA, PA 19104-4306
(215) 662-2737

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
A73182
CA
207N00000X
Dermatology Physician
Primary
MD440722
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A731820
CA
Enumeration date
11/20/2006
Last updated
12/14/2012
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