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General NPI Number Information
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NPI Number | 1629378542
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Entity Type | Individual
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Provider Name | DANIELLE RAJA NP
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Gender | Female
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Dates
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Enumeration Date | 10/26/2010
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Last Update Date | 10/28/2015
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Provider Practice Location Address
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Address Line | 67 UNION ST SUITE 501
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City | NATICK
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State | MA
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Zip | 01760-7700
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Country | US
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Telephone | 508-655-0525
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Fax |
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Provider Business Mailing Address
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Address Line | 526 MAIN ST 302
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City | ACTON
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State | MA
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Zip | 01720-3301
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Country | US
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Telephone | 978-849-7507
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Fax | 978-371-0522
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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 | RN281673
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License Number State | MA
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