Provider Demographics
NPI:1790823565
Name:REDDY, SUMITHRA (PAC)
Entity Type:Individual
Prefix:
First Name:SUMITHRA
Middle Name:
Last Name:REDDY
Suffix:
Gender:F
Credentials:PAC
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Mailing Address - Street 1:380 OXFORD VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-8304
Mailing Address - Country:US
Mailing Address - Phone:215-949-5000
Mailing Address - Fax:215-807-8235
Practice Address - Street 1:1648 HUNTINGDON PIKE
Practice Address - Street 2:
Practice Address - City:MEADOWBROOK
Practice Address - State:PA
Practice Address - Zip Code:19046-8001
Practice Address - Country:US
Practice Address - Phone:215-938-2749
Practice Address - Fax:215-938-3829
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2019-09-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA051672363AS0400X
PAOA000959363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical