Provider Demographics
NPI:1376779629
Name:REDDY, NEELIMA KOOL (PT)
Entity Type:Individual
Prefix:
First Name:NEELIMA
Middle Name:KOOL
Last Name:REDDY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 CONNECTICUT AVE NW
Mailing Address - Street 2:APT #406
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-2538
Mailing Address - Country:US
Mailing Address - Phone:330-519-3792
Mailing Address - Fax:
Practice Address - Street 1:6410 ROCKLEDGE DR STE 600
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1844
Practice Address - Country:US
Practice Address - Phone:301-581-8030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH107142251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic