Basic Information
| Provider Information | |||||||||
| NPI: | 1467871095 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | READER | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD/MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 147 PELHAM ST | ||||||||
| Address2: | |||||||||
| City: | METHUEN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018442060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9786863491 | ||||||||
| FaxNumber: | 9786863472 | ||||||||
| Practice Location | |||||||||
| Address1: | 147 PELHAM ST | ||||||||
| Address2: | |||||||||
| City: | METHUEN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018442060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9786863491 | ||||||||
| FaxNumber: | 9786833472 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2014 | ||||||||
| LastUpdateDate: | 12/04/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 125.064503 | IL | N | Allopathic & Osteopathic Physicians | Family Medicine | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 275001 | MA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | S400507796 | 01 | MA | MEDICARE | OTHER |