Individual
CELESTE RAQUEL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
300 LONGWOOD AVE, WOLBACH 2, BOSTON, MA 02115-5724
(617) 355-6363
Mailing address
300 LONGWOOD AVE, WOLBACH 2, BOSTON, MA 02115-5724
(617) 355-6363
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
156465
MA
2080C0008X
Child Abuse Pediatrics Physician
Primary
156465
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015177
NIEGHBORHOOD HEALTH
MA
05
—
0114341
—
MA
01
—
156465
TUFTS
MA
01
—
B501026
CIGNA
MA
01
—
J23289
BLUE CROSS
MA
01
—
PP788
HARVARD PILGRIM
MA
Enumeration date
01/23/2006
Last updated
04/21/2015
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