Provider Demographics
NPI:1275795338
Name:MALIREDDY, JYOTHIRMAYI (MD)
Entity Type:Individual
Prefix:
First Name:JYOTHIRMAYI
Middle Name:
Last Name:MALIREDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1464 W STONINGTON DR
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335
Mailing Address - Country:US
Mailing Address - Phone:484-237-8930
Mailing Address - Fax:484-593-4668
Practice Address - Street 1:106 SCHUBERT DR
Practice Address - Street 2:STE 300
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335
Practice Address - Country:US
Practice Address - Phone:484-237-8930
Practice Address - Fax:484-593-4668
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD433670207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine