Provider Demographics
NPI:1467871095
Name:READER, JESSICA (MD/MPH)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:READER
Suffix:
Gender:F
Credentials:MD/MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 PELHAM ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-2060
Mailing Address - Country:US
Mailing Address - Phone:978-686-3491
Mailing Address - Fax:978-686-3472
Practice Address - Street 1:147 PELHAM ST
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-2060
Practice Address - Country:US
Practice Address - Phone:978-686-3491
Practice Address - Fax:978-683-3472
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.064503207Q00000X
390200000X
MA275001207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS400507796OtherMEDICARE