Provider Demographics
NPI:1831492792
Name:SRINIVASA REDDY MEDICAL PC
Entity type:Organization
Organization Name:SRINIVASA REDDY MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:SRINIVASA
Authorized Official - Middle Name:REDDY
Authorized Official - Last Name:ADAPA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-374-3851
Mailing Address - Street 1:123 LOGANS WAY
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-3403
Mailing Address - Country:US
Mailing Address - Phone:718-882-2432
Mailing Address - Fax:718-231-1067
Practice Address - Street 1:3950 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-3026
Practice Address - Country:US
Practice Address - Phone:718-882-2432
Practice Address - Fax:718-231-1067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-15
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY218854173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty