Provider Demographics
NPI:1366296907
Name:HASKELL, RAYGHAN SCHULTZ LARICK (MD)
Entity type:Individual
Prefix:
First Name:RAYGHAN
Middle Name:SCHULTZ LARICK
Last Name:HASKELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RAYGHAN
Other - Middle Name:SCHULTZ
Other - Last Name:LARICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:110 IRVING ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-3017
Mailing Address - Country:US
Mailing Address - Phone:202-877-8271
Mailing Address - Fax:202-877-6292
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3017
Practice Address - Country:US
Practice Address - Phone:202-877-8271
Practice Address - Fax:202-877-6292
Is Sole Proprietor?:No
Enumeration Date:2024-04-11
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program