Provider Demographics
NPI:1215044060
Name:RASKIN, ELSA MARIA (MD)
Entity Type:Individual
Prefix:
First Name:ELSA
Middle Name:MARIA
Last Name:RASKIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4974
Mailing Address - Country:US
Mailing Address - Phone:212-889-8600
Mailing Address - Fax:212-779-3699
Practice Address - Street 1:21/2 DEARFIELD DRIVE SUITE 102
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-0683
Practice Address - Country:US
Practice Address - Phone:917-617-4513
Practice Address - Fax:212-779-3699
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT041001208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH51246Medicare UPIN