Provider Demographics
NPI:1154563989
Name:READ, CLODAGH MAIREAD (L'AC)
Entity type:Individual
Prefix:MS
First Name:CLODAGH
Middle Name:MAIREAD
Last Name:READ
Suffix:
Gender:F
Credentials:L'AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49-07 43RD AVEUNE
Mailing Address - Street 2:APT 1
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377
Mailing Address - Country:US
Mailing Address - Phone:917-361-0789
Mailing Address - Fax:
Practice Address - Street 1:39 W 14TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-7489
Practice Address - Country:US
Practice Address - Phone:917-361-0789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY25 004 001171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist