Provider Demographics
NPI:1861546319
Name:DAVID, MARGERY RIFKIN (L CSW)
Entity type:Individual
Prefix:MRS
First Name:MARGERY
Middle Name:RIFKIN
Last Name:DAVID
Suffix:
Gender:F
Credentials:L CSW
Other - Prefix:
Other - First Name:MARGERY
Other - Middle Name:BETH
Other - Last Name:RIFKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:1 RYDER CT
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-6157
Mailing Address - Country:US
Mailing Address - Phone:631-243-3298
Mailing Address - Fax:631-243-6010
Practice Address - Street 1:1 RYDER COURT
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-6157
Practice Address - Country:US
Practice Address - Phone:631-243-3298
Practice Address - Fax:631-243-6010
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR02429411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCS942OtherOXFORD
NY01964305Medicaid
NYCS942OtherOXFORD
S05124Medicare UPIN