Provider Demographics
NPI:1619049855
Name:READE, BRIAN M (DPM)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:M
Last Name:READE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 SOUTH RD
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-6027
Mailing Address - Country:US
Mailing Address - Phone:845-454-0120
Mailing Address - Fax:845-790-2131
Practice Address - Street 1:1910 SOUTH RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-6027
Practice Address - Country:US
Practice Address - Phone:845-454-0120
Practice Address - Fax:845-790-2131
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005536213E00000X, 213EP1101X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02186616Medicaid
361261OtherMVP
71344OtherGHI HMO
P00037174OtherRR MEDICARE
1893215OtherUNITED HEALTHCARE
6202187OtherGHI
P2751776OtherOXFORD
10033475OtherCDPHP
PO55369BOtherWORKERS COMP
PO9011OtherBLUE CROSS
P00037174OtherRR MEDICARE
71344OtherGHI HMO
NYA400060999Medicare PIN
PO9011OtherBLUE CROSS
NYPB0PB01110Medicare PIN
NY6301970001Medicare NSC