Provider Demographics
NPI:1922079417
Name:REDDY, SIVAKUMAR A
Entity Type:Individual
Prefix:DR
First Name:SIVAKUMAR
Middle Name:A
Last Name:REDDY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6161 TRANSIT ROAD
Mailing Address - Street 2:SUITE # 6
Mailing Address - City:E. AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051
Mailing Address - Country:US
Mailing Address - Phone:716-688-6161
Mailing Address - Fax:
Practice Address - Street 1:6161 TRANSIT RD
Practice Address - Street 2:SUITE # 6
Practice Address - City:E AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-2606
Practice Address - Country:US
Practice Address - Phone:716-688-6161
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY141380207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine