Provider Demographics
NPI:1073583845
Name:REDDY, H D (MD)
Entity Type:Individual
Prefix:
First Name:H
Middle Name:D
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 SAW MILL RIVER RD
Mailing Address - Street 2:211
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502
Mailing Address - Country:US
Mailing Address - Phone:914-693-3633
Mailing Address - Fax:914-479-0629
Practice Address - Street 1:1055 SAW MILL RIVER RD
Practice Address - Street 2:211
Practice Address - City:ARDSLEY
Practice Address - State:NY
Practice Address - Zip Code:10502
Practice Address - Country:US
Practice Address - Phone:914-693-3633
Practice Address - Fax:914-479-0629
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111539207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00200871Medicaid
NY00200871Medicaid
B77857Medicare UPIN