Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | MD456107 | PA |
NPI | 1396944906 |
---|---|
Provider Name | Dr. Ashwini P. Reddy |
First Address | Spring, TX 77379 |
Second Address | Philadelphia, PA 19104-4395 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2007 |
Last Update Date | 19/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1030896110002 | (05) | PA |