Provider Demographics
NPI:1558362301
Name:ALEJO, TERESITA M (MD)
Entity Type:Individual
Prefix:DR
First Name:TERESITA
Middle Name:M
Last Name:ALEJO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:52 HAVEN ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867
Mailing Address - Country:US
Mailing Address - Phone:781-944-2050
Mailing Address - Fax:781-944-0232
Practice Address - Street 1:52 HAVEN ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867
Practice Address - Country:US
Practice Address - Phone:781-944-2050
Practice Address - Fax:781-944-0232
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA158559174400000X
MA15859208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110060582AMedicaid
MA3187845Medicaid
MAA31840Medicare ID - Type Unspecified