Provider Demographics
NPI:1770633802
Name:READING FAMILY MEDICAL CENTER
Entity Type:Organization
Organization Name:READING FAMILY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:LAZARO
Authorized Official - Middle Name:
Authorized Official - Last Name:PEPEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-374-4576
Mailing Address - Street 1:40 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19602-1016
Mailing Address - Country:US
Mailing Address - Phone:610-374-4576
Mailing Address - Fax:610-374-5010
Practice Address - Street 1:40 S 5TH ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19602-1016
Practice Address - Country:US
Practice Address - Phone:610-374-4576
Practice Address - Fax:610-374-5010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD062674207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG56902Medicare UPIN