Provider Demographics
NPI:1174535942
Name:RAHA, PAULA H (NP)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:H
Last Name:RAHA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 BUCKMAN DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-6021
Mailing Address - Country:US
Mailing Address - Phone:407-592-4921
Mailing Address - Fax:
Practice Address - Street 1:231 FOREST ST
Practice Address - Street 2:HOLLISTER HALL, FIRST FLOOR, SUITE 130
Practice Address - City:BABSON PARK
Practice Address - State:MA
Practice Address - Zip Code:02457-5353
Practice Address - Country:US
Practice Address - Phone:781-239-6363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP917407363L00000X
MARN2321885363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner