Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 168949 | NY |
NPI | 1033296439 |
---|---|
Provider Name | Dr. Dominick F. Reda |
First Address | Scarsdale, NY 10583-1616 |
Second Address | Yonkers, NY 10701-4008 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 21/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01125819 | (05) | NY |
D92102 | (02) | NY |