Provider Demographics
NPI:1033267711
Name:RASKIN, RICHARD JAY (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:JAY
Last Name:RASKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ENTERPRISE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-7998
Mailing Address - Country:US
Mailing Address - Phone:207-621-9580
Mailing Address - Fax:207-621-9581
Practice Address - Street 1:15 ENTERPRISE DR STE 200
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330
Practice Address - Country:US
Practice Address - Phone:207-621-9580
Practice Address - Fax:207-621-9581
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD20866207R00000X, 207RR0500X
VA0101232581207RR0500X
MDD0026763207RR0500X
CT47412207RR0500X
PAMD026139E207RR0500X
MA239253207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine