Wilson, Celeste Raquel

Wilson, Celeste Raquel is an individual health care provider with primary practice located at 300 Longwood Ave Wolbach 2, Boston MA 02115-5724. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Child Abuse Pediatrics. Allopathic & Osteopathic Physicians / Child Abuse Pediatrics is her primary health care specialty. Wilson, Celeste Raquel can be contacted via phone (617) 355-6363.

Contact Information

Primary practice address
300 Longwood Ave Wolbach 2 Boston MA 02115-5724
Phone: (617) 355-6363
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 156465 Massachusetts
Allopathic & Osteopathic Physicians / Child Abuse Pediatrics 2080C0008X 156465 Massachusetts

Profile Details

NPI number 1215907464
LBN Legal business name Wilson, Celeste Raquel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2006
Last updated Apr 21st, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215907464 NPPES
Massachusetts Other 0015177 NIEGHBORHOOD HEALTH
Massachusetts MEDICAID 0114341 NIEGHBORHOOD HEALTH
Massachusetts Other 156465 NIEGHBORHOOD HEALTH
Massachusetts Other J23289 NIEGHBORHOOD HEALTH
Massachusetts Other PP788 NIEGHBORHOOD HEALTH
Massachusetts Other B501026 NIEGHBORHOOD HEALTH

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