Provider Demographics
NPI:1801919170
Name:ELSA M. RASKIN PHYSICIAN PC
Entity type:Organization
Organization Name:ELSA M. RASKIN PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELSA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:RASKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-889-8600
Mailing Address - Street 1:2 1 2 DEARFIELD DRIVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831
Mailing Address - Country:US
Mailing Address - Phone:203-861-6620
Mailing Address - Fax:
Practice Address - Street 1:2 1 2 DEARFIELD DRIVE
Practice Address - Street 2:SUITE 102
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831
Practice Address - Country:US
Practice Address - Phone:203-861-6620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty