MEDICARE: DR. JULIA M READE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	55296	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	717821	OTHER	MA	TUFTS HEALTH PLAN

General Provider Information

NPI Number	:	1629067913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIA M READE M.D.

Provider Business Mailing Address
First Line	:	321 WALNUT ST
Second Line	:
City	:	NEWTONVILLE
State	:	MA
Zip	:	02460-1927
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	321 WALNUT ST
Second Line	:
City	:	NEWTONVILLE
State	:	MA
Zip	:	02460-1927
Country	:	US
Telephone Number	:	617-552-5131
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	02/15/2011

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