Provider Demographics
NPI:1053451567
Name:RASKIN, KEITH BRIAN (MD)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:BRIAN
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:PO BOX 1807
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10156
Mailing Address - Country:US
Mailing Address - Phone:212-263-4263
Mailing Address - Fax:212-685-2667
Practice Address - Street 1:901 45TH ST, KIMMEL BLDG
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3340
Practice Address - Country:US
Practice Address - Phone:561-844-5255
Practice Address - Fax:561-844-5245
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1586761207X00000X
FL159511207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD77562Medicare UPIN
NY18F561Medicare PIN