Provider Demographics
NPI:1053453654
Name:REDDY, NIRMALA M (MD)
Entity Type:Individual
Prefix:DR
First Name:NIRMALA
Middle Name:M
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:207 SPRAIN DR SCARSDALE NY 10583
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583
Mailing Address - Country:US
Mailing Address - Phone:914-968-6935
Mailing Address - Fax:845-207-9378
Practice Address - Street 1:984 NORTH BROADWAY SUITE L08
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701
Practice Address - Country:US
Practice Address - Phone:914-968-6935
Practice Address - Fax:845-207-9378
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2011-01-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1677892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01189211Medicaid
NY01189211Medicaid
F88029Medicare UPIN