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NPI Code Detail

MEDICARE: SONJA K RASLAVICUS DO

MEDICARE: SONJA K RASLAVICUS DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician12536NH
2207P00000XEmergency Medicine Physician217591MA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00196623OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3000000042885OTHERBMC HEALTHNET PLAN
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5AA25559OTHERHARVARD PILGRIM
604Y005461MA02OTHERNHANTHEM
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154496982
Entity Type Code : Individual
Provider Name (Legal Business Name) : SONJA K RASLAVICUS DO
Provider Business Mailing Address
First Line : 500 MERRIMACK ST
Second Line :
City : LAWRENCE
State : MA
Zip : 01843-1756
Country : US
Telephone Number : 978-557-8800
Fax Number : 978-557-8633
Provider Business Practice Location Address
First Line : 370 MERRIMACK ST
Second Line :
City : LAWRENCE
State : MA
Zip : 01843-1788
Country : US
Telephone Number : 978-557-8800
Fax Number : 978-557-8633
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2006
Last Update Date : 08/10/2021

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Directions to “ SONJA K RASLAVICUS DO” Practice Location

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