Provider Demographics
NPI:1841392305
Name:REDDY, JAIDEEP (MD)
Entity Type:Individual
Prefix:DR
First Name:JAIDEEP
Middle Name:
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8639 105TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-1529
Mailing Address - Country:US
Mailing Address - Phone:718-847-0063
Mailing Address - Fax:888-464-1041
Practice Address - Street 1:8639 105TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-1529
Practice Address - Country:US
Practice Address - Phone:718-847-0063
Practice Address - Fax:888-464-1041
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY189763207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease