Basic Information
| Provider Information | |||||||||
| NPI: | 1972531275 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALENCAR | ||||||||
| FirstName: | RAQUEL | ||||||||
| MiddleName: | OLIVA | ||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D., PH.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | OLIVA | ||||||||
| OtherFirstName: | MARIA | ||||||||
| OtherMiddleName: | RAQUEL | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 75 FRANCIS ST | ||||||||
| Address2: | BRIGHAM AND WOMEN'S HOSPITAL, DEPARTMENT OF RADIOLOGY | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021156110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177326304 | ||||||||
| FaxNumber: | 6177326317 | ||||||||
| Practice Location | |||||||||
| Address1: | 75 FRANCIS ST | ||||||||
| Address2: | BRIGHAM AND WOMEN'S HOSPITAL - DEPARTMENT OF RADIOLOGY | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021156110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177326304 | ||||||||
| FaxNumber: | 6177326317 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2006 | ||||||||
| LastUpdateDate: | 10/30/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 223404 | MA | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085B0100X | 230538 | MA | N | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | 2085R0204X | 230538 | MA | N | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology |
No ID Information.