Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 235776 | MA |
N | 207ND0101X | MOHS-Micrographic Surgeon | 235776 | MA |
NPI | 1407015266 |
---|---|
Provider Name | Dr. Kavitha Reddy |
First Address | North Falmouth, MA 02556-2841 |
Second Address | North Falmouth, MA 02556-2841 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2008 |
Last Update Date | 04/03/2021 |