Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 250429 | NY |
N | 208600000X | Surgeon | 250429 | NY |
N | 2086S0102X | Surgical Critical Care | 250429 | NY |
Y | 2086S0127X | Trauma Surgeon | 250429 | NY |
NPI | 1093945875 |
---|---|
Provider Name | Dr. Srinivas H Reddy |
First Address | Old Westbury, NY 11568-1502 |
Second Address | Bronx, NY 10461 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2009 |
Last Update Date | 19/03/2015 |