Provider Demographics
NPI:1063462026
Name:REDDY, USHA (MD)
Entity Type:Individual
Prefix:DR
First Name:USHA
Middle Name:
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 JOHN OLDS DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06042-8798
Mailing Address - Country:US
Mailing Address - Phone:860-643-5218
Mailing Address - Fax:860-646-1261
Practice Address - Street 1:555 MAIN ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-5196
Practice Address - Country:US
Practice Address - Phone:860-643-5218
Practice Address - Fax:860-646-1261
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT031248208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT206622OtherPREFERRED ONE
2V6569OtherHEALTH NET
010031248CT06OtherANTHEM BLUE CROSS
1080020OtherAETNA
031248OtherCONNECTICARE
CT00131248807OtherBLUE CARE FAMILY PLAN