Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0002X | Hospice and Palliative Medicine | 61758 | TN |
Y | 207RH0002X | Hospice and Palliative Medicine | MD17821 | RI |
NPI | 1194176396 |
---|---|
Provider Name | Nishitha Reddy |
First Address | Providence, RI 02904-5719 |
Second Address | Providence, RI 02904-5719 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2016 |
Last Update Date | 12/10/2021 |