Healthcare Provider Details

I. General information

NPI: 1649684838
Provider Name (Legal Business Name): EUGENE RAGGI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2014
Last Update Date: 01/27/2023
Certification Date: 01/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 S LINCOLN AVE
LEBANON PA
17042-7529
US

IV. Provider business mailing address

1700 S LINCOLN AVE
LEBANON PA
17042-7529
US

V. Phone/Fax

Practice location:
  • Phone: 717-272-6621
  • Fax: 717-228-6034
Mailing address:
  • Phone: 717-272-6621
  • Fax: 717-228-6034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMT206208
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberMD466397
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: