Provider Demographics
NPI:1295776979
Name:MCHALE, JOHN EDWARD (OD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:EDWARD
Last Name:MCHALE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 MAIN ST.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867
Mailing Address - Country:US
Mailing Address - Phone:781-942-9400
Mailing Address - Fax:781-942-9405
Practice Address - Street 1:315 MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867
Practice Address - Country:US
Practice Address - Phone:781-942-9400
Practice Address - Fax:781-942-9405
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3446152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW15868OtherBC/BS OF MASS
MA0356611Medicaid
MA759316OtherTUFTS HEALTH CARE
MA151960OtherHARVARD PILGRIM HEALTHCAR
MA215221202OtherUNITED HEALTHCARE
MA759316OtherTUFTS HEALTH CARE
MA215221202OtherUNITED HEALTHCARE