Healthcare Provider Details

I. General information

NPI: 1558362301
Provider Name (Legal Business Name): TERESITA M ALEJO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 09/19/2022
Certification Date: 09/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 HAVEN ST
READING MA
01867
US

IV. Provider business mailing address

52 HAVEN ST
READING MA
01867
US

V. Phone/Fax

Practice location:
  • Phone: 781-944-2050
  • Fax: 781-944-0232
Mailing address:
  • Phone: 781-944-2050
  • Fax: 781-944-0232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number158559
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number15859
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: