Provider Demographics
NPI:1942594197
Name:CANETE, RAQUEL (MD)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:
Last Name:CANETE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RAQUEL
Other - Middle Name:ZARAH
Other - Last Name:GROSSMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:263 FARMINGTON AVE
Mailing Address - Street 2:CENTER ON AGING
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-5215
Mailing Address - Country:US
Mailing Address - Phone:860-679-3958
Mailing Address - Fax:
Practice Address - Street 1:263 FARMINGTON AVE
Practice Address - Street 2:CENTER ON AGING
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-5215
Practice Address - Country:US
Practice Address - Phone:860-679-3958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT056662207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine