Provider Demographics
NPI:1740177450
Name:RASOOL, LARAIB (PA-C)
Entity type:Individual
Prefix:
First Name:LARAIB
Middle Name:
Last Name:RASOOL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MORROW WAY
Mailing Address - Street 2:
Mailing Address - City:SLIPPERY ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:16057-1314
Mailing Address - Country:US
Mailing Address - Phone:336-862-3099
Mailing Address - Fax:
Practice Address - Street 1:1 MORROW WAY
Practice Address - Street 2:
Practice Address - City:SLIPPERY ROCK
Practice Address - State:PA
Practice Address - Zip Code:16057-1314
Practice Address - Country:US
Practice Address - Phone:336-862-3099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant