Provider Demographics
NPI:1962518688
Name:RAGGIO, CATHLEEN (MD)
Entity type:Individual
Prefix:
First Name:CATHLEEN
Middle Name:
Last Name:RAGGIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 29234
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-9234
Mailing Address - Country:US
Mailing Address - Phone:631-329-6925
Mailing Address - Fax:631-329-6951
Practice Address - Street 1:333 EARLE OVINGTON BLVD
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-3610
Practice Address - Country:US
Practice Address - Phone:516-222-6826
Practice Address - Fax:516-222-6893
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150901207XP3100X
CT035146207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00000278680 13OtherEMPIRE PLAN
NY00000278680 13OtherUNITED HEALTHCARE
NY49D992OtherEMPIRE BCBS
NY21003099125OtherBEECH STREET
NY00922770Medicaid
NY00000278680 13OtherEMPIRE PLAN
NY00000278680 13OtherUNITED HEALTHCARE