Provider Demographics
NPI:1225178981
Name:READING PEDIATRICS ASSOCIATES
Entity Type:Organization
Organization Name:READING PEDIATRICS ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-944-2050
Mailing Address - Street 1:36 WOBURN ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-2903
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:36 WOBURN ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-2903
Practice Address - Country:US
Practice Address - Phone:781-944-2050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA71266305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9769439Medicaid
MAM15670OtherBLUE CROSS BLUE SHIELD
MA600506OtherTUFTS
MAM15670OtherBLUE CROSS BLUE SHIELD
MA9769439Medicaid