Healthcare Provider Details

I. General information

NPI: 1003209883
Provider Name (Legal Business Name): KENDRA READ P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2015
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 CYPRESS ST
BROOKLINE MA
02445-6776
US

IV. Provider business mailing address

330 MOUNT AUBURN ST DEPARTMENT OF SURGERY
CAMBRIDGE MA
02138-5502
US

V. Phone/Fax

Practice location:
  • Phone: 617-383-6255
  • Fax:
Mailing address:
  • Phone: 617-499-5150
  • Fax: 617-499-5593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA5253
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: