Provider Demographics
NPI:1598866774
Name:REDDY MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:REDDY MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:SUDMAKAR
Authorized Official - Middle Name:A
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-337-7333
Mailing Address - Street 1:356 FREEPORT STREET
Mailing Address - Street 2:SUITE 207
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068
Mailing Address - Country:US
Mailing Address - Phone:724-337-7333
Mailing Address - Fax:724-337-7398
Practice Address - Street 1:356 FREEPORT STREET
Practice Address - Street 2:SUITE 207
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068
Practice Address - Country:US
Practice Address - Phone:724-337-7333
Practice Address - Fax:724-337-7398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 043886E207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01748642Medicaid
D91928Medicare UPIN
024118Medicare ID - Type Unspecified