Provider Demographics
NPI:1225608094
Name:LOKIREDDY, VENKATA SIVA SUDHAKAR REDDY
Entity Type:Individual
Prefix:
First Name:VENKATA SIVA
Middle Name:SUDHAKAR REDDY
Last Name:LOKIREDDY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1251 S CEDAR CREST BLVD STE 202A
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6214
Mailing Address - Country:US
Mailing Address - Phone:610-402-2893
Mailing Address - Fax:610-402-5763
Practice Address - Street 1:1251 S CEDAR CREST BLVD STE 202A
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6214
Practice Address - Country:US
Practice Address - Phone:610-402-2893
Practice Address - Fax:610-402-5763
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-25
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty