Provider Demographics
NPI:1598894727
Name:SATISH REDDY MD PLLC
Entity Type:Organization
Organization Name:SATISH REDDY MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SATISH
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-580-5850
Mailing Address - Street 1:140 E 83RD ST
Mailing Address - Street 2:APT 10 C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-1929
Mailing Address - Country:US
Mailing Address - Phone:212-580-5850
Mailing Address - Fax:212-665-9412
Practice Address - Street 1:140 E 83RD ST
Practice Address - Street 2:APT 10 C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-1929
Practice Address - Country:US
Practice Address - Phone:212-580-5850
Practice Address - Fax:212-665-9412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184084207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05658OtherGHI MEDICARE
NY01374863Medicaid
NY01374863Medicaid
NYWWP011Medicare PIN