Healthcare Provider Details

I. General information

NPI: 1215570676
Provider Name (Legal Business Name): DAVID R. RAYMOND DNP, FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2019
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 ROSEMARY STREET SUITE C
NEEDHAM MA
02494-3259
US

IV. Provider business mailing address

145 ROSEMARY STREET SUITE C
NEEDHAM MA
02494-3259
US

V. Phone/Fax

Practice location:
  • Phone: 781-235-7900
  • Fax: 781-237-9930
Mailing address:
  • Phone: 781-235-7900
  • Fax: 781-237-9930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRN2319463
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: