Provider Demographics
NPI:1194018275
Name:REDDY, PRASHANTH (MD)
Entity Type:Individual
Prefix:
First Name:PRASHANTH
Middle Name:
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2417 JERICHO TPKE # 310
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-4710
Mailing Address - Country:US
Mailing Address - Phone:212-498-8982
Mailing Address - Fax:212-208-2519
Practice Address - Street 1:7846 PARSONS BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11366-1957
Practice Address - Country:US
Practice Address - Phone:212-498-8982
Practice Address - Fax:212-208-2519
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-23
Last Update Date:2023-06-21
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Provider Licenses
StateLicense IDTaxonomies
NY269035207LP2900X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine