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Organization

SIMON RASKIN DPM PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SIMON RASKIN DPM (PRESIDENT)
(718) 332-7771
Entity
Organization

Contact information

Practice address
1409 GRAVESEND NECK RD, BROOKLYN, NY 11229-4322
(718) 332-7771
Mailing address
1409 GRAVESEND NECK RD, BROOKLYN, NY 11229-4322
(718) 332-7771

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N005608
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02195893
NY
01
PK5251
BLUE CROSS BLUE SHIELD
NY
Enumeration date
08/19/2006
Last updated
12/18/2014
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