Provider Demographics
NPI:1952340085
Name:REDDY, KUMAR S (MD)
Entity Type:Individual
Prefix:
First Name:KUMAR
Middle Name:S
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6860 AUSTIN ST
Mailing Address - Street 2:SUITE 502
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4245
Mailing Address - Country:US
Mailing Address - Phone:718-925-6263
Mailing Address - Fax:718-925-6251
Practice Address - Street 1:6860 AUSTIN ST
Practice Address - Street 2:SUITE 502
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4245
Practice Address - Country:US
Practice Address - Phone:718-925-6263
Practice Address - Fax:718-925-6251
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2008-11-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY104996207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD04061Medicare UPIN
NY9255PYMedicare ID - Type Unspecified