Healthcare Provider Details

I. General information

NPI: 1619121563
Provider Name (Legal Business Name): ROBERT P. RAGGI MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2008
Last Update Date: 11/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7554 METROPOLITAN AVE
MIDDLE VILLAGE NY
11379-2639
US

IV. Provider business mailing address

PO BOX 7096
STOCKTON CA
95267-0096
US

V. Phone/Fax

Practice location:
  • Phone: 718-894-4200
  • Fax:
Mailing address:
  • Phone: 209-956-7725
  • Fax: 209-956-7733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT P RAGGI
Title or Position: PRESIDENT/OWNER
Credential: MD
Phone: 718-894-4200