Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 2242 | TX |
N | 213ES0131X | Foot Surgery | P89395 | NY |
NPI | 1245647247 |
---|---|
Provider Name | Ravinder Reddy |
First Address | Bronx, NY 10457-2545 |
Second Address | Rockwall, TX 75032-7808 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2014 |
Last Update Date | 17/03/2018 |