Provider Demographics
NPI:1982935680
Name:RASKINA, ILONA (NP)
Entity Type:Individual
Prefix:
First Name:ILONA
Middle Name:
Last Name:RASKINA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 QUENTIN RD FL 7
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-2214
Mailing Address - Country:US
Mailing Address - Phone:718-431-8936
Mailing Address - Fax:718-431-9607
Practice Address - Street 1:902 QUENTIN RD FL 7
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2214
Practice Address - Country:US
Practice Address - Phone:718-431-8936
Practice Address - Fax:718-431-9607
Is Sole Proprietor?:No
Enumeration Date:2010-01-19
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF340751363LG0600X
NYF305195363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology