Provider Demographics
NPI:1083817670
Name:RASKIN, MARJORIE JANE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:JANE
Last Name:RASKIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:PROF
Other - First Name:FREDERICK
Other - Middle Name:PAUL
Other - Last Name:GREENLEAF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:38 W 9TH ST APT 10
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8914
Mailing Address - Country:US
Mailing Address - Phone:212-254-7428
Mailing Address - Fax:
Practice Address - Street 1:38 W 9TH ST APT 10
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8914
Practice Address - Country:US
Practice Address - Phone:212-254-7428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1378092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry