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General NPI Number Information
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NPI Number | 1093335903
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Entity Type | Individual
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Provider Name | NICHOLAS ALEXANDER READ DO
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Gender | Male
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Dates
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Enumeration Date | 04/21/2020
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 1291 BOSTON POST RD STE 105
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City | MADISON
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State | CT
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Zip | 06443-3476
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Country | US
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Telephone | 860-358-5100
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Fax | 860-358-8655
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Provider Business Mailing Address
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Address Line | 28 CRESCENT ST
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City | MIDDLETOWN
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State | CT
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Zip | 06457-3654
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Country | US
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Telephone | 860-358-6000
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Fax | 860-358-8661
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 79181
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License Number State | CT
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