Provider Demographics
NPI:1558091694
Name:ROJAS, RAPHAEL
Entity Type:Individual
Prefix:
First Name:RAPHAEL
Middle Name:
Last Name:ROJAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MANN ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602-3414
Mailing Address - Country:US
Mailing Address - Phone:774-804-1110
Mailing Address - Fax:
Practice Address - Street 1:4 MANN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602-3414
Practice Address - Country:US
Practice Address - Phone:774-804-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical