Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 218854 | NY |
NPI | 1083667935 |
---|---|
Provider Name | Dr. Srinivasa Reddy Adapa |
First Address | Bronx, NY 10466-3026 |
Second Address | Bronx, NY 10466-3026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 12/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02356150 | (05) | NY |
218854 | LICENSE NY STATE (01) | NY |
BA7290036 | FEDERAL (01) | |
H44785 | (02) | NY |