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General NPI Number Information
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NPI Number | 1053064188
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Entity Type | Individual
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Provider Name | RAQUEL CARINA GONCALVES APN
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Gender | Female
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Dates
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Enumeration Date | 01/29/2022
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 865 STONE ST FL 1
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City | RAHWAY
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State | NJ
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Zip | 07065-2742
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Country | US
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Telephone | 973-322-7636
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Fax | 973-324-5257
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Provider Business Mailing Address
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Address Line | 865 STONE ST FL 1
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City | RAHWAY
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State | NJ
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Zip | 07065-2742
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Country | US
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Telephone | 732-499-6380
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Fax | 732-680-7909
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NJ01125100
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License Number State | NJ
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