Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 290361-1 | NY |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD454534 | PA |
NPI | 1043533755 |
---|---|
Provider Name | Ms. Neha Bandaru Reddy |
First Address | Erie, PA 16507-1537 |
Second Address | Erie, PA 16507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2010 |
Last Update Date | 28/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
411918 | (02) | PA |