Healthcare Provider Details

I. General information

NPI: 1508523895
Provider Name (Legal Business Name): RACHEL ZAGARELLA PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2021
Last Update Date: 06/14/2025
Certification Date: 06/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MARINA PARK DR STE 1410
BOSTON MA
02210-1874
US

IV. Provider business mailing address

1 MARINA PARK DR STE 1410
BOSTON MA
02210-1874
US

V. Phone/Fax

Practice location:
  • Phone: 781-785-9220
  • Fax: 781-205-1648
Mailing address:
  • Phone: 781-785-9220
  • Fax: 781-205-1648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2310186
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2310186
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: