Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 118368 | NY |
NPI | 1801005087 |
---|---|
Provider Name | Dr. Surendranath K Reddy |
First Address | Woodmere, NY 11598 |
Second Address | Flushing, NY 11355 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 08/07/2007 |