Provider Demographics
NPI:1568438075
Name:RASKIN, KEVIN ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ANDREW
Last Name:RASKIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:YAW 3 ORTHOPAEDIC ASSOCIATES
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-724-3700
Practice Address - Fax:617-726-6823
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2013-07-10
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Provider Licenses
StateLicense IDTaxonomies
MA214176207X00000X
NY22903207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2007690Medicaid
MAJ26075OtherBCBS MA
MA214176OtherTUFTS HEALTH PLAN
MA2007690Medicaid
MA214176OtherTUFTS HEALTH PLAN