Provider Demographics
NPI:1518603620
Name:REDDY, NEELIMA (MS, RDN, LD)
Entity Type:Individual
Prefix:
First Name:NEELIMA
Middle Name:
Last Name:REDDY
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5419 LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:BENTLEYVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44022-3523
Mailing Address - Country:US
Mailing Address - Phone:917-514-0026
Mailing Address - Fax:
Practice Address - Street 1:2141 OVERLOOK RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44106-5995
Practice Address - Country:US
Practice Address - Phone:917-514-0026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH133V00000X
OHLD.09510133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered