Healthcare Provider Details

I. General information

NPI: 1851230981
Provider Name (Legal Business Name): RAQUEL CAMPOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 SPARHAWK ST
BRIGHTON MA
02135
US

IV. Provider business mailing address

2 MURDOCK ST
BRIGHTON MA
02135-2818
US

V. Phone/Fax

Practice location:
  • Phone: 857-559-3081
  • Fax: 857-559-3081
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: